This also flows with the scenario when there is initial hypotension (only one SBP <90) and CMS requires complete fluid (30ml/kg) resuscitation. If the complete amount is not administered the case fails the measure. I would recommend that if physicians document ‘reasons’ for not giving the appropriate amount of fluids at the appropriate rate those cases should not fail the measure. Just a thought.
From: Sepsisgroups [mailto:[email protected]] On Behalf Of Barnes-Daly, Mary Ann, MS, RN, CCRN, DC Sent: Monday, April 17, 2017 1:27 PM To: Townsend, Sean, M.D. Cc: [email protected] Subject: Re: [Sepsis Groups] [**External**] One low MAP can trigger Severe Sepsis presentation Fantastic news, thank you 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]<mailto:[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: Townsend, Sean, M.D. Sent: Monday, April 17, 2017 10:27 AM To: Barnes-Daly, Mary Ann, MS, RN, CCRN, DC <[email protected]<mailto:[email protected]>> Cc: Nelson, Kathy <[email protected]<mailto:[email protected]>>; [email protected]<mailto:[email protected]> Subject: Re: [Sepsis Groups] [**External**] One low MAP can trigger Severe Sepsis presentation This has been built into new specs effective Jan 2018. Can't do it faster. In these instances, in the meantime, if the doc states the value was erroneous it can be ignored. This documentation can happen at the time the value was obtained, or via query with your clinical documentation integrity team. On Apr 17, 2017, at 6:38 AM, Barnes-Daly, Mary Ann, MS, RN, CCRN, DC <[email protected]<mailto:[email protected]>> wrote: This sender failed our fraud detection checks and may not be who they appear to be. Learn about spoofing<http://aka.ms/LearnAboutSpoofing> Feedback<http://aka.ms/SafetyTipsFeedback> Yes, I have feedback that occurs and it is problematic. We need to bring this to CMS. I would suggest that in the same way 2 consecutive BPs are required to identify SEPTIC SHOCK after fluids, the same should be true to signify the onset of hypotension. 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]<mailto:[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 Nelson, Kathy Sent: Friday, April 07, 2017 12:43 PM To: [email protected]<mailto:[email protected]> Subject: [**External**] [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. 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. 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