Sepsis Core Measures - Are They Worth the Cost?

Area of Science:

• Emergency Medicine
• Critical Care
• Health Services Research

Background:

• Sepsis core measures were implemented in 2015 by CMS and The Joint Commission to reduce sepsis-related morbidity and mortality.
• Emerging evidence questions the efficacy of early goal-directed therapy components underlying these measures.

Purpose of the Study:

• To evaluate resource utilization following the implementation of sepsis core measures.
• To determine if adherence to sepsis core measures impacts patient mortality rates.

Main Methods:

• Retrospective data collection over 3 years in an academic emergency department for patients with suspected sepsis.
• Tracking of laboratory tests (lactates, blood cultures) and antibiotic orders (vancomycin, piperacillin/tazobactam).
• Comparison of sepsis patient mortality rates during 3-month periods each year.

Main Results:

• No significant difference in sepsis patient mortality rates was observed across the 3 study years.
• A notable increase in the administration of piperacillin/tazobactam and vancomycin occurred.
• Significant increases in the number of lactates and blood cultures ordered per patient were recorded.

Conclusions:

• Sepsis core measures did not improve patient mortality rates.
• There was a substantial rise in resource utilization for sepsis care.
• Increased resource use led to higher costs for patients and hospitals without a corresponding mortality benefit.