Author Interviews, Critical Care - Intensive Care - ICUs, Infections / 02.10.2021
CMS Mandated Sepsis Scoring Resulted in More Testing But No Change in Outcomes
MedicalResearch.com Interview with:
Chanu Rhee, MD, MPH
Harvard Medical School and Harvard Pilgrim Health Institute
Boston, MA
MedicalResearch.com: What is the background for this study?
Response: Sepsis is a leading cause of death, disability, and healthcare costs. This has triggered regulators and hospitals to invest heavily in improving sepsis recognition and care. Most notably, the Centers for Medicare & Medicaid Services (CMS) implemented the Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) by the in October 2015. SEP-1 requires hospitals to report compliance with a 3 and 6 hour sepsis care bundle, which includes initial and repeat lactate measurements, blood culture orders, broad-spectrum antibiotic, specific quantities of fluid boluses for hypotension, vasopressors for persistent hypotension, and documentation of a repeat volume and perfusion assessment for patients with septic shock.
While SEP-1 has helped raise awareness of sepsis and catalyzed sepsis quality improvement initiatives around the country, concerns have been raised about its potential unintended consequences -- particularly around increasing unnecessary broad spectrum antibiotic use -- and the strength of evidence supporting the measure. In this study, we used detailed clinical data from a diverse cohort of hospitals to assess whether SEP-1 implementation was associated with changes in key processes of care and mortality in patients with suspected sepsis. (more…)