scholarly journals Modify Centers for Medicare & Medicaid Services' Sepsis Core Measure (SEP-1) Now to Optimize Care for COVID-19

2021 ◽  
Author(s):  
Harry Peled ◽  
Nhu Quyen Dau ◽  
Shelley Schoepflin Sanders
Keyword(s):  
Core Measure

scholarly journals 603. Evaluating the Effects of Centers for Medicare & Medicaid Services Sepsis Core Measure in a Community Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S364-S364
Author(s):  
So Kim ◽  
Peter Ty
Keyword(s):  
Length Of Stay ◽  
Improve Patient Care ◽  
Prescribing Patterns ◽  
Hospital Length Of Stay ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Negative Consequences ◽  
Treatment Standards ◽  
Core Measure ◽  
Core Measures

Abstract Background Sepsis is the leading cause of morbidity and mortality in hospitals, accounting for 30% of deaths in the emergency department. In 2001, Rivers et al. found that early goal-directed therapy (EGDT) led to significant mortality benefits, which ultimately prompted United States Centers for Medicare and Medicaid Services (CMS) to mandate EGDT in hospitals through its implementation of sepsis core measures. CMS core measures are intended to facilitate the broad implementation of evidence-based treatment standards, and while voluntary, non-compliance is associated with negative consequences to both quality and financial metrics for participating hospitals. However, while quality measures are implemented to ultimately improve patient care, its effects on the healthcare system can also include negative unanticipated consequences. This study seeks to characterize the effect of the CMS sepsis core measure on sepsis identification, antimicrobial utilization, and nd specific prescribing patterns. Methods This is a retrospective cohort review of 175 randomly selected patients greater than and equal to 18 years of age with admitting diagnosis of sepsis, severe sepsis, and septic shock from January 2013 to December 2018. Medical charts were reviewed for relevant data. Results Comparing ED antibiotic prescribing patterns between pre-and post-Sepsis CMS Core Measures, there was no statistical difference in total antibiotics usage and the initiation of broad antibiotics. There was a decreased time to the first antibiotic, an increase in receiving Normal Saline boluses post-Sepsis CMS Core Measures. Conclusion 1. No significant changes were seen in ED antibiotic prescribing behaviors with regard to volume and spectrum 2. ED time to antibiotic administration was significantly faster after the implementation of CMS Core Measures. Also, there was a significant positive shift in time to fluid bolus, fluid selection, and fluid volume 3. Significantly decreased ICU length of stay after implementation of CMS Core Measures possibly associated with above behavior changes 4. No outcomes benefits (mortality, hospital length of stay) realized after implementation of CMS Core Measures Disclosures All Authors: No reported disclosures

Neuroprotective Core Measure 5: Minimizing Stress and Pain—Neonatal Pain Management Practices During Heel Lance and Venipuncture in Ontario, Canada

2015 ◽  
Vol 15 (3) ◽  
pp. 116-123 ◽  
Author(s):  
Denise Harrison ◽  
Jessica Reszel ◽  
Jodi Wilding ◽  
Koowsar Abdulla ◽  
Mariana Bueno ◽  
...  
Keyword(s):  
Pain Management ◽  
Management Practices ◽  
Neonatal Pain ◽  
Heel Lance ◽  
Core Measure

Abstract 111: Assessing Statin Therapy and Lipid Profile Goals 6 Months After Percutaneous Coronary Intervention at a Veterans Hospital

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Dmitry Blumenkrants ◽  
Saifullah M Siddiqui ◽  
Karthik Challa ◽  
Amit Ladani ◽  
Adhir Shroff
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Statin Therapy ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Percutaneous Coronary ◽  
Core Measure ◽  
Study Population ◽  
Artery Disease

Background: Patients undergoing percutaneous coronary intervention (PCI) represent a high-risk cohort for cardiovascular events. Lipid lowering therapy is an established core measure of secondary prevention in coronary artery disease management. The NCEP-ATPIII advises a minimum LDL level < 100 mg/dL in patients with coronary heart disease (CHD). However, further research suggests that an LDL < 70 is more desirable in this population to further reduce adverse CHD endpoints. Methods: We conducted a retrospective, observational study on all patients undergoing PCI at an urban Veterans Hospital from September 2004 to December 2011. Statin use and lipid profiles at 6 months post-PCI were compared to pre-PCI values. Results: A total of 1052 unique patients had PCI during the study period. Approximately 70% of patients were on statins at baseline, which improved to 88% at 6 months post-PCI (p < 0.0001). LDL levels improved significantly when compared to pre-PCI levels, from a mean of 97.2 to 85.1 (p < 0.0001). With regards to NCEP-ATPIII guidelines, the proportion of the study population that met minimum LDL goals (<100) post-PCI increased from 59% to 76% (p < 0.0001). The percentage of patients meeting ideal goals for LDL (<70) increased from 23% to 33% (p < 0.0001). Conclusion: In patients who have undergone PCI, there was significant improvement in LDL levels. At six months, there was an increase in usage of statin therapy. Furthermore there was a statistically significant increase in adherence to NCEP-ATIII guidelines at both the minimum and ideal LDL levels on follow-up after PCI.

Sepsis Update: A New Core Measure of Quality

2016 ◽  
Vol 47 (5) ◽  
pp. 204-206
Author(s):  
Fiona Winterbottom ◽  
Misty Jenkins ◽  
Marlene Alonzo
Keyword(s):  
Core Measure

scholarly journals 787. Improving ED Sepsis Care

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S348-S349
Author(s):  
William A Sloan ◽  
Sandra Kemmerly ◽  
Surma Jain ◽  
Ashley Shreves ◽  
Kirsten Dauterive
Keyword(s):  
Early Identification ◽  
Care Process ◽  
Care Bundle ◽  
Antibiotic Administration ◽  
Life Threatening Illness ◽  
High Acuity ◽  
Life Threatening ◽  
Core Measure ◽  
Sepsis And Septic Shock ◽  
Sepsis Care

Abstract Background Sepsis is a severe, life-threatening illness in response to an infection from the body’s immune system. Sepsis can progress rapidly, causing hypotension, organ failure, and death. Mortality from severe forms of sepsis and septic shock range between 20% to 50%, but with appropriate and timely treatment, mortality decreases to 5%-10%. Before completing the Improving ED Sepsis Care project, there was only 18% and 12% compliance with the CMS 3 and 6-hour core measure bundles, respectively, within the Ochsner Main Campus Emergency Department. Methods A multi-disciplinary team followed Lean methodology for process improvement. The failure to identify sepsis patients as high acuity in triage was a key root causes identified. There was also a need to simplify the process and workflow to facilitate antibiotic administration and resuscitation. A triage tool called “Code Sepsis” was created to allow for early identification of severe forms of sepsis, to ensure an appropriate ESI score, and to dedicate immediate attention from staff. A provider order set was created that included the necessary lab work standardized antibiotics. Results 3-hour bundle compliance increased from 18% to 90% following the intervention. Improvements were noted in time to antibiotic administration, volume resuscitation, and appropriate initiation of vasopressors. The addition of the “Code Sepsis” triage tool decreased the median time to antibiotic administration from 1 hour 53 minutes to 33 minutes. Improvements were also noted in the elements of the 6-hour “perfect care” bundle; however, compliance rates were lower than goal. Conclusion Early identification and appropriate treatment of sepsis is key to improving survival. Despite widespread knowledge early treatment, many EDs struggle to meet the CMS sepsis care bundles. Utilizing the Lean framework allowed the improvement team to breakdown a multi-siloed, interdependent care process. Disclosures All authors: No reported disclosures.

Depression in Adults with Intellectual Disability. Part 2: A Pilot Study

1997 ◽  
Vol 31 (2) ◽  
pp. 243-251 ◽  
Author(s):  
Julian P. Davis ◽  
Fiona K. Judd ◽  
Helen Herrman
Keyword(s):  
Intellectual Disability ◽  
Depressive Disorder ◽  
Diagnostic Criteria ◽  
Patient Group ◽  
Depressive Disorders ◽  
Psychiatric Evaluation ◽  
Depressed Patients ◽  
Standard Assessment ◽  
Core Measure ◽  
Dsm Iv

Objectives: To identify adults with intellectual disability (ID) with a depressive disorder referred to a tertiary consultation clinic for psychiatric assessment; to investigate common presenting features of depression in adults with ID; to assess the utility of visual analogue scale (VAS) measures of emotion/behaviour, the CORE measure of psychomotor disturbance, and substitutive diagnostic criteria in the assessment of depressive disorders in this patient group. Method: Over a 6-month period 47 patients were seen for psychiatric evaluation. Patients in whom a diagnosis of depression was made were further assessed using: VAS measures of depression, irritability, verbal aggression, physical aggression, temper outbursts, regressed behaviour; CORE measure of psychomotor disturbance; and substitutive diagnostic criteria designed by the authors. Results: Ten patients were found to have a depressive disorder. Substitutive criteria resulted in a greater rate of diagnosis than standard DSM-IV criteria. The VAS measure of irritability was highly scored for all 10 depressed patients. All 10 depressed patients were assigned to the melancholic subgroup according to CORE score. Conclusions: Standard assessment measures and diagnostic criteria may require modification to enhance their utility in this patient group. Melancholic features require further investigation.

The New Mandate from The Joint Commission on the Perinatal Care Core Measure of Exclusive Breast Milk Feeding

2013 ◽  
Vol 29 (3) ◽  
pp. 291-295 ◽  
Author(s):  
Lori Feldman-Winter ◽  
April Douglass-Bright ◽  
Melissa C. Bartick ◽  
Jennifer Matranga
Keyword(s):  
Breast Milk ◽  
Perinatal Care ◽  
Joint Commission ◽  
Core Measure ◽  
Milk Feeding ◽  
The Joint Commission

1345: CORE MEASURE ROUNDS TO INCREASE COMPLIANCE IN A BUSY ICU

2020 ◽  
Vol 48 (1) ◽  
pp. 649-649
Author(s):  
Alice Chan ◽  
Oren Friedman ◽  
Karen Krechmery ◽  
Tara Cohen ◽  
Tao Shen ◽  
...  
Keyword(s):  
Core Measure
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