What Are We Measuring?
Sepsis can be a life-threatening and progressive inflammatory response to infection. It is a leading cause of inpatient mortality, accounting for more than 1.5 million hospitalizations and 250,000 deaths in the United States each year. Research has shown that rapid identification and treatment can save lives and reduce the long-term impact on survivors.
In July 2015, the Centers for Medicare and Medicaid adopted a measure called the Severe Sepsis and Septic Shock Early Management Bundle which requires hospitals to follow a series of time-sensitive treatments and tests for patients with sepsis. The treatments and tests include:
- Administer broad-spectrum antibiotics
- Administer fluid for patients with low blood pressure or a high lactate level
- Administer vasopressor medication for patient with low blood pressure
- Measure lactate, which can identify low oxygen levels in the blood, at specific time intervals
- Obtain blood cultures
How We Are Performing?
Severe Sepsis and Septic Shock Early Management Bundle Compliance
Higher scores are better
This measure shows how often patients diagnosed with sepsis received all elements of the sepsis bundle at the appropriate time interval.
Mass General Source: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Adult Patient Experience Survey
Comparison Group Source: CMS HCAHPS surve.
What Are We Doing to Improve?
Massachusetts General Hospital is committed to improving the detection and treatment of sepsis.
Our electronic health record has been designed to flag patients who meet the criteria for possible sepsis and septic shock. This system brings possible sepsis cases to our clinicians’ attention, which helps with early detection. The system includes shortcuts to help healthcare providers quickly document a sepsis diagnosis and prescribe the correct treatment for sepsis (when appropriate), which helps ensure that all members of the care team are aware of the patient’s condition and that appropriate actions are being taken. We are working to spread awareness about this early detection system to clinicians throughout the hospital.
Additionally, we track sepsis cases where we did not meet all criteria in the bundle to identify opportunities for improvement and provide feedback to clinicians on these cases when appropriate. While we agree that early detection of sepsis is crucial to saving lives, we are advocating for continued refinement of the Severe Sepsis and Septic Shock Early Management Bundle.