Sepsis mandatory reporting

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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].

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"[4].

Related is the voluntary Bundled Payments for Care Improvement (BPCI) initiative in 2013[5]. After the first 9 months of the BPCI, 88 of 2918 eligible hospitals participated in BPCI for sepsis[6]. No difference was found in the quality or costs of sepsis care[6].

New York state reporting

References

  1. 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.
  2. 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. 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.
  4. 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.
  5. 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)
  6. 6.0 6.1 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.


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