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Sepsis: The knock-out punch

Muhammad Ali and Patty Duke made headlines this year as they passed from sepsis, but they are just the tip of the iceberg. More than 1 million Americans are diagnosed with sepsis each year and between 28-50% die. In an effort to improve quality of care and reduce the costs associated with this deadly infection, The Centers for Medicare and Medicaid Services (CMS) has implemented financial incentives and core measures for reporting and best detection and treatment. This is the most complex CMS core measure ever required so hospitals are making process and technology changes to improve communication among team members across facilities in order to report to external agencies and stop sepsis in its tracks.

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My phone rang and it was that dreaded call that makes you wish you never picked up.  My aunt was hospitalized and went into cardiac arrest twice the night before. Doctors weren’t sure if she would pull through and they were calling in the family to say their last goodbyes. I dropped everything, canceled my meetings, picked up my mother, and raced to Inova Fairfax Hospital. We arrived to find her in the ICU in a medically-induced coma hanging in that space between life and death. Then we learned that her prognosis was even grimmer: she had developed sepsis.

Sepsis occurs when chemicals released into the bloodstream to fight an infection trigger inflammatory responses throughout the body. This can trigger a cascade of changes in the patient that damage multiple organ systems, causing them to fail. What makes this so tricky is it’s somewhat unclear when patients start to develop sepsis because any type of infection can lead to inflammation. While trying to fight off these ailments, the body can go into overdrive and septic shock. Time is of the essence so care coordination in hospitals across multiple departments and clinical specialties is required.

Fortunately, my story has a happy ending. With significant medical intervention and loving support, my aunt narrowly escaped what appeared to be a certain death. The next time I saw her, she said that doctors told her the chances of surviving were so slim that her case was being studied as a medical miracle.

Many sepsis patients are not so lucky. Muhammad Ali, Patty Duke, and even Christopher Reeve made headlines when they succumbed to this dreaded infection. Like my aunt, patients are often admitted with another diagnosis and develop sepsis, which delivers the knock-out punch.

 

Stopping sepsis

The Agency for Healthcare Research and Quality lists sepsis as the most expensive condition treated in U.S. hospitals[1], and CMS has made it a priority. In the fall of 2015, CMS rolled out a new core measure set for sepsis. Core measures are like checklists of best care practices that a hospital must deliver, document, and report to the Agency. If they don’t meet all the criteria and fail the core measure, it impacts their Annual Payment Update, which is like their base salary from Medicare. Since the average hospital receives nearly 60% of its reimbursement from Medicare, the financial losses can be staggering, especially if those losses compound over multiple years putting the hospital in financial jeopardy.

Many Nuance clients say that sepsis is the most difficult measure set that CMS has ever required and they’ve shared how their hospitals have successfully developed processes and leveraged information systems to coordinate, document, and report care as part of new sepsis criteria. A strong Clinical Documentation Improvement (CDI) program can play a key role in positively impacting sepsis awareness and early intervention.

Join us for a webinar, “The New Face of Sepsis: Are You Ready for July 1?” where Deborah Larkin-Carney, vice president of quality at RWJBarnabas, will discuss some of the upcoming changes to this measure set and some of their best practices.

 

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