Published in the December 2016 issue of Today’s Hospitalist
SEPSIS IS ONE of the most challenging conditions physicians see in the hospital. But as our cover story explains, meeting Medicare’s new core measure on sepsis can be nearly as tough as treating the condition itself.
The CMS’s sepsis bundle primarily focuses on time, so the new core measure has hospitals chasing the clock. But as our coverage points out, having to deliver several components of sepsis care within fixed time frames is just one of many obstacles that hospitalists say they are running into.
One of the biggest flaws of the core measure? It uses an all-or-nothing type of calculus to judge hospital compliance, so you have to meet 100% of the measure’s many time goals to succeed. Meet 90% of them, and you’ve failed. Dramatically improve your compliance—from 30% to 70%, for example—and that’s still a miss.
Documentation is another major stumbling block. Even when clinicians deliver rapid-fire sepsis care, the precise language they have to use to document that care can be a major source of frustration.
As hospitalists work to meet the core measure, they face their own challenges. They have to initiate and manage rapid care of septic patients while carrying much higher patient loads than doctors in the ICU or the ED. And the evidence on sepsis is changing so quickly that clinicians and staff must be trained, then trained again.
But the reality is that without the specialty’s efforts, bundle compliance rates for hospitals would be much worse. Hospitalists are now digging in to bring their expertise in system re-design and hospital innovation to bear—and to start gaining ground on a killer condition.
Here’s wishing you all a happy and peaceful holiday season.
Editor & Publisher