Emily; We discovered the discrepancy as well. The short story is that the mathematical algorithm in the monitor that is used to calculate the MAP is far more sophisticated (and therefore more accurate) than the simple formula that we had been using - sys + 2dys/3. Therefore we always accept the MAP from the monitor as the most accurate.
You can have this verified by your vendor. I am not permitted to disclose the vendor that we used on this listserve Thanks, MARY ANN BARNES-DALY MS RN CCRN DC | Clinical Performance Improvement Consultant Quality & Clinical Effectiveness Team | Office of Patient Experience Sutter Health -2200 River Plaza Drive, Sacramento, CA 95833 Mobile 916.200.5604| [email protected] "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." ~R. Buckminster Fuller From: Sepsisgroups [mailto:[email protected]] On Behalf Of Emily C. McKinney Sent: Monday, April 17, 2017 5:56 AM To: Nelson, Kathy <[email protected]>; [email protected] Subject: [**External**] Re: [Sepsis Groups] One low MAP can trigger Severe Sepsis presentation WARNING: This email originated outside of the Sutter Health email system! DO NOT CLICK links if the sender is unknown and never provide your User ID or Password. We have been having the same problem. However, the issue we have found are some inconsistencies in proper MAP calculations. The auto-calculated MAPS are lower than when calculating them manually. We are looking into this but in the meantime we are having patients "fall into the fluid bucket" who normally should not. And this is also causing us to be non-compliant. Sincerely, Emily C. McKinney (Swiss), BSN, RN Sepsis Coordinator Quality Excellence Reicert Health Building Suite 6003 St. Joseph Mercy Health System tel: 734-712-2319 | cell:734-395-2859 email: [email protected]<mailto:[email protected]> www.stjoeshealth.org<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.stjoeshealth.org%2F&data=02%7C01%7Cbarnesm4%40sutterhealth.org%7Cdeaf017e920c473b59c608d485b0900a%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636280440790113565&sdata=RevCkXaczgJgD5eqbpn3kJwSbsgSBRolyJbUASnD0go%3D&reserved=0> Facebook<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.facebook.com%2Fsjmhs&data=02%7C01%7Cbarnesm4%40sutterhealth.org%7Cdeaf017e920c473b59c608d485b0900a%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636280440790113565&sdata=Vg6FrqyYeQd7zFuDZkhV1glTh6j3nTc4v0ZeBR%2Bn2UE%3D&reserved=0> | Twitter<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.twitter.com%2Fstjoes_health&data=02%7C01%7Cbarnesm4%40sutterhealth.org%7Cdeaf017e920c473b59c608d485b0900a%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636280440790113565&sdata=TDzAAh5Rs31dW8aKQCBOWwqonAMukS9BoCrNXvxxtwM%3D&reserved=0> [cid:[email protected]] From: Sepsisgroups [mailto:[email protected]] On Behalf Of Nelson, Kathy Sent: Friday, April 07, 2017 3:43 PM To: [email protected]<mailto:[email protected]> Subject: [External] [Sepsis Groups] One low MAP can trigger Severe Sepsis presentation Question posed by our physician leadership: Is anyone else having a problem with their CMS bundles when it comes to a low MAP. Our EMR captures every vital sign and if the auto-calculated MAP falls only momentarily to 64, it will trigger our data abstractors to establish a diagnosis of hypotension and put the patient into the severe sepsis category without necessarily having any of the other organ dysfunction criteria for the diagnosis. This results in a fall out on the bundle and makes us non-compliant from CMS data collection purposes. Has anyone else had a similar EMR issue and if so, how did you deal with it? Thanks! Kathy Nelson, MBA, CPHQ, RHIA Public Data Manager Advocate Health Care Center for Health Information Services (CHIS) 3075 Highland Parkway, Suite 600 Downers Grove, IL 60515 P: 630- 929-6782 (Internal: 55-6782) [email protected]<mailto:[email protected]> This e-mail, and any attachments thereto, is intended only for use by the addressee(s) named herein and may contain legally privileged and/or confidential information. If you are not the intended recipient of this e-mail (or the person responsible for delivering this document to the intended recipient), you are hereby notified that any dissemination, distribution, printing or copying of this e-mail, and any attachments thereto, is strictly prohibited. If you have received this e-mail in error, please respond to the individual sending the message and permanently delete the original and any copy of any e-mail and any printout thereof. Confidentiality Notice: This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.
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