Skip to main content Accessibility help
×
Home

Variability in determining sepsis time zero and bundle compliance rates for the centers for medicare and medicaid services SEP-1 measure

  • Chanu Rhee (a1) (a2), Sarah R. Brown (a2), Travis M. Jones (a3), Cara O’Brien (a4), Anupam Pande (a5), Yasir Hamad (a5), Amy L. Bulger (a6), Kathleen A. Tobin (a7), Anthony F. Massaro (a2), Deverick J. Anderson (a3), David K. Warren (a5), Michael Klompas (a1) (a2) and for the CDC Prevention Epicenters Program (a1) (a2) (a3) (a4) (a5) (a6) (a7)...

Abstract

We compared sepsis “time zero” and Centers for Medicare and Medicaid Services (CMS) SEP-1 pass rates among 3 abstractors in 3 hospitals. Abstractors agreed on time zero in 29 of 80 (36%) cases. Perceived pass rates ranged from 9 of 80 cases (11%) to 19 of 80 cases (23%). Variability in time zero and perceived pass rates limits the utility of SEP-1 for measuring quality.

Copyright

Corresponding author

Author for correspondence: Chanu Rhee, MD, MPH, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401, Boston, MA 02215. E-mail: crhee@bwh.harvard.edu

References

Hide All
1. Centers for Medicare and Medicaid Services. QualityNet—Inpatient Hospitals Specifications Manual. Quality website. https://www.qualitynet.org. Accessed March 19, 2018.
2. Venkatesh, AK, Slesinger, T, Whittle, J, et al. Preliminary performance on the new CMS Sepsis-1 national quality measure: early insights from the emergency quality network (E-QUAL). Ann Emerg Med 2018;71:1015.
3. Barbash, IJ, Rak, KJ, Kuza, CC, Kahn, JM. Hospital perceptions of Medicare’s sepsis quality reporting initiative. J Hosp Med 2017;12:963968.
4. Klompas, M, Rhee, C. The CMS sepsis mandate: right disease, wrong measure. Ann Intern Med 2016;165:517518.
5. Aaronson, EL, Filbin, MR, Brown, DF, Tobin, K, Mort, EA. New mandated Centers for Medicare and Medicaid Services requirements for sepsis reporting: caution from the field. J Emerg Med 2017;52:109116.
6. McHugh, ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012;22:276282.
7. Stevens, JP, Kachniarz, B, Wright, SB, et al. When policy gets it right: variability in US hospitals’ diagnosis of ventilator-associated pneumonia*. Crit Care Med 2014;42:497503.
8. ReCal3: Reliability for 3+ coders. dfreelon.org website. http://dfreelon.org/utils/recalfront/recal3/. Accessed March 19, 2018.
9. Rhee, C, Kadri, SS, Danner, RL, et al. Diagnosing sepsis is subjective and highly variable: a survey of intensivists using case vignettes. Crit Care 2016;20:89.
10. Angus, DC, Seymour, CW, Coopersmith, CM, et al. A framework for the development and interpretation of different sepsis definitions and clinical criteria. Crit Care Med 2016;44:e113e121.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed