In January, I blogged about ways in which infection preventionists can contribute to improved patient outcomes beyond our typical “space” of HAI prevention. Two scenarios in which infection preventionists can further impact patient outcomes are sepsis prevention and reduction of readmissions.
More recently, an April 2015 study published in Critical Care Medicine, “Frequency, Cost, and Risk Factors of Readmissions Among Severe Sepsis Survivors,” measured readmission rates and the associated cost and mortality of readmissions in severe sepsis survivors.
In this study, of 43,452 sepsis survivors, 26% required readmission within 30 days and 48% within 180 days. The cumulative mortality rate of sepsis survivors attributed to readmissions was 8%, and the estimated cost was over $1.1 billion. Among survivors, 25% required multiple readmissions within 180 days and accounted for 77% of all readmissions. It was found that 30- and 180-day readmissions are common in severe sepsis survivors. Readmissions after severe sepsis hospitalization result in substantial mortality, cost, and are not exclusive to pneumonia.
Additionally, the drum beat of increased reporting mandates continues. The Centers for Medicare & Medicaid Services (CMS) will require hospitals participating in Inpatient Quality Reporting (IQR) Program to collect data for the Severe Sepsis and Septic Shock: Management Bundle measure (NQF #0500) beginning with October 1, 2015 discharges. This measure was adopted for the Fiscal Year 2017 payment determination in the Calendar Year 2015 Inpatient Prospective Payment System (IPPS) Final Rule.
So, how can infection preventionists participate in sepsis prevention? We are already in the business of surveillance. What is your hospital’s current approach to early detection and prevention of sepsis? Are you officially a part of that effort? Can your current surveillance processes be combined with other routinely available patient data to streamline collection of sepsis-related data required by NQF 0500?
Evaluate how you can increase the “footprint” of infection prevention’s contribution to sepsis prevention at your facility. Your efforts could make a direct impact on your hospital’s financial bottom line. And, of course, you can hopefully impact the ultimate bottom line of improving patient safety.
Frequency, Cost, and Risk Factors of Readmissions Among Severe Sepsis Survivors. Andrew J. Goodwin, MD, MSCR; David A. Rice, MD; Kit N. Simpson, DrPH; Dee W. Ford, MD, MSCR
Crit Care Med. 2015;43(4):738-746.