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==Federal reporting== | ==Federal reporting== | ||
Mandatory reporting of sepsis quality measures, "SEP-1" was started by [[Centers for Medicare and Medicaid Services]] in October 1, 2015 as a value based purchase with the possibility of financial penalties<ref name="pmid25167590">{{cite journal| author=Centers for Medicare and Medicaid Services (CMS), HHS| title=Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule. | journal=Fed Regist | year= 2014 | volume= 79 | issue= 163 | pages= 49853-50536 | pmid=25167590 | doi= | pmc= | url=https://www.federalregister.gov/documents/2014/08/22/2014-18545/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the }} </ref><ref name="pmid25291572">{{cite journal| author=Cooke CR, Iwashyna TJ| title=Sepsis mandates: improving inpatient care while advancing quality improvement. | journal=JAMA | year= 2014 | volume= 312 | issue= 14 | pages= 1397-8 | pmid=25291572 | doi=10.1001/jama.2014.11350 | pmc=4813658 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25291572 }} </ref><ref name="pmid27294338">{{cite journal| author=Klompas M, Rhee C| title=The CMS Sepsis Mandate: Right Disease, Wrong Measure. | journal=Ann Intern Med | year= 2016 | volume= 165 | issue= 7 | pages= 517-518 | pmid=27294338 | doi=10.7326/M16-0588 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27294338 }} </ref>. | Mandatory reporting of sepsis quality measures, "SEP-1" was started by [[Centers for Medicare and Medicaid Services]] in October 1, 2015 as a value based purchase with the possibility of financial penalties<ref name="pmid25167590">{{cite journal| author=Centers for Medicare and Medicaid Services (CMS), HHS| title=Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule. | journal=Fed Regist | year= 2014 | volume= 79 | issue= 163 | pages= 49853-50536 | pmid=25167590 | doi= | pmc= | url=https://www.federalregister.gov/documents/2014/08/22/2014-18545/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the }} </ref><ref name="pmid25291572">{{cite journal| author=Cooke CR, Iwashyna TJ| title=Sepsis mandates: improving inpatient care while advancing quality improvement. | journal=JAMA | year= 2014 | volume= 312 | issue= 14 | pages= 1397-8 | pmid=25291572 | doi=10.1001/jama.2014.11350 | pmc=4813658 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25291572 }} </ref><ref name="pmid27294338">{{cite journal| author=Klompas M, Rhee C| title=The CMS Sepsis Mandate: Right Disease, Wrong Measure. | journal=Ann Intern Med | year= 2016 | volume= 165 | issue= 7 | pages= 517-518 | pmid=27294338 | doi=10.7326/M16-0588 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27294338 }} </ref>. Variations in hospital mortality contributed to the rationale for SEP-1<ref name="pmid30024430">{{cite journal| author=Hatfield KM, Dantes RB, Baggs J, Sapiano MRP, Fiore AE, Jernigan JA et al.| title=Assessing Variability in Hospital-Level Mortality Among U.S. Medicare Beneficiaries With Hospitalizations for Severe Sepsis and Septic Shock. | journal=Crit Care Med | year= 2018 | volume= 46 | issue= 11 | pages= 1753-1760 | pmid=30024430 | doi=10.1097/CCM.0000000000003324 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30024430 }} </ref>. As of 2017, 87% of eligible hospitals reported compliance measures with variation in rates of compliance<ref name="pmid30585827">{{cite journal| author=Barbash IJ, Davis B, Kahn JM| title=National Performance on the Medicare SEP-1 Sepsis Quality Measure. | journal=Crit Care Med | year= 2019 | volume= 47 | issue= 8 | pages= 1026-1032 | pmid=30585827 | doi=10.1097/CCM.0000000000003613 | pmc=6588513 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30585827 }} </ref>. | ||
Concerns about the reporting is the complexity of determining compliance as the documentation for chart reviews if 120 pages and may require 2-3 hours per chart to review<ref name="pmid27294338">{{cite journal| author=Klompas M, Rhee C| title=The CMS Sepsis Mandate: Right Disease, Wrong Measure. | journal=Ann Intern Med | year= 2016 | volume= 165 | issue= 7 | pages= 517-518 | pmid=27294338 | doi=10.7326/M16-0588 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27294338 }} </ref>. The SEP-1 rule has been criticized for focusing on processes of care that are hard to measure rather than more easily measured rates and outcomes<ref name="pmid27294338"/>. As an exapmle, abstractos of clinical charts usually disagree over determing "time zero"<ref name="pmid29932042">{{cite journal| author=Rhee C, Brown SR, Jones TM, O'Brien C, Pande A, Hamad Y et al.| title=Variability in determining sepsis time zero and bundle compliance rates for the centers for medicare and medicaid services SEP-1 measure. | journal=Infect Control Hosp Epidemiol | year= 2018 | volume= 39 | issue= 8 | pages= 994-996 | pmid=29932042 | doi=10.1017/ice.2018.134 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29932042 }} </ref>. | Concerns about the reporting is the complexity of determining compliance as the documentation for chart reviews if 120 pages and may require 2-3 hours per chart to review<ref name="pmid27294338">{{cite journal| author=Klompas M, Rhee C| title=The CMS Sepsis Mandate: Right Disease, Wrong Measure. | journal=Ann Intern Med | year= 2016 | volume= 165 | issue= 7 | pages= 517-518 | pmid=27294338 | doi=10.7326/M16-0588 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27294338 }} </ref>. The SEP-1 rule has been criticized for focusing on processes of care that are hard to measure rather than more easily measured rates and outcomes<ref name="pmid27294338"/>. As an exapmle, abstractos of clinical charts usually disagree over determing "time zero"<ref name="pmid29932042">{{cite journal| author=Rhee C, Brown SR, Jones TM, O'Brien C, Pande A, Hamad Y et al.| title=Variability in determining sepsis time zero and bundle compliance rates for the centers for medicare and medicaid services SEP-1 measure. | journal=Infect Control Hosp Epidemiol | year= 2018 | volume= 39 | issue= 8 | pages= 994-996 | pmid=29932042 | doi=10.1017/ice.2018.134 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29932042 }} </ref>. | ||
Revision as of 21:43, 13 August 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
Synonyms and keywords: sepsis syndrome; septic shock; septicemia
Federal reporting
Mandatory reporting of sepsis quality measures, "SEP-1" was started by Centers for Medicare and Medicaid Services in October 1, 2015 as a value based purchase with the possibility of financial penalties[1][2][3]. Variations in hospital mortality contributed to the rationale for SEP-1[4]. As of 2017, 87% of eligible hospitals reported compliance measures with variation in rates of compliance[5].
Concerns about the reporting is the complexity of determining compliance as the documentation for chart reviews if 120 pages and may require 2-3 hours per chart to review[3]. The SEP-1 rule has been criticized for focusing on processes of care that are hard to measure rather than more easily measured rates and outcomes[3]. As an exapmle, abstractos of clinical charts usually disagree over determing "time zero"[6].
Related is the voluntary Bundled Payments for Care Improvement (BPCI) initiative in 2013[7]. After the first 9 months of the BPCI, 88 of 2918 eligible hospitals participated in BPCI for sepsis[8]. No difference was found in the quality or costs of sepsis care[8].
New York state reporting
References
- ↑ Centers for Medicare and Medicaid Services (CMS), HHS (2014). "Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule". Fed Regist. 79 (163): 49853–50536. PMID 25167590.
- ↑ Cooke CR, Iwashyna TJ (2014). "Sepsis mandates: improving inpatient care while advancing quality improvement". JAMA. 312 (14): 1397–8. doi:10.1001/jama.2014.11350. PMC 4813658. PMID 25291572.
- ↑ 3.0 3.1 3.2 Klompas M, Rhee C (2016). "The CMS Sepsis Mandate: Right Disease, Wrong Measure". Ann Intern Med. 165 (7): 517–518. doi:10.7326/M16-0588. PMID 27294338.
- ↑ Hatfield KM, Dantes RB, Baggs J, Sapiano MRP, Fiore AE, Jernigan JA; et al. (2018). "Assessing Variability in Hospital-Level Mortality Among U.S. Medicare Beneficiaries With Hospitalizations for Severe Sepsis and Septic Shock". Crit Care Med. 46 (11): 1753–1760. doi:10.1097/CCM.0000000000003324. PMID 30024430.
- ↑ Barbash IJ, Davis B, Kahn JM (2019). "National Performance on the Medicare SEP-1 Sepsis Quality Measure". Crit Care Med. 47 (8): 1026–1032. doi:10.1097/CCM.0000000000003613. PMC 6588513 Check
|pmc=value (help). PMID 30585827. - ↑ Rhee C, Brown SR, Jones TM, O'Brien C, Pande A, Hamad Y; et al. (2018). "Variability in determining sepsis time zero and bundle compliance rates for the centers for medicare and medicaid services SEP-1 measure". Infect Control Hosp Epidemiol. 39 (8): 994–996. doi:10.1017/ice.2018.134. PMID 29932042.
- ↑ Bundled Payments for Care Improvement (BPCI) initiative: general information. Baltimore: Centers for Medicare and Medicaid Services, 2017 (http://innovation.cms.gov/initiatives/bundled-payments/opens in new tab)
- ↑ 8.0 8.1 Joynt Maddox KE, Orav EJ, Zheng J, Epstein AM (2018). "Evaluation of Medicare's Bundled Payments Initiative for Medical Conditions". N Engl J Med. 379 (3): 260–269. doi:10.1056/NEJMsa1801569. PMID 30021090.