Many studies report that the incidence of sepsis, the state of body-wide inflammation that occurs with severe infection, has increased dramatically over time. It is a leading cause of death and was the single most costly condition treated in hospitals in 2011.
Standardized protocols aimed at improving sepsis identification and treatment have become common in hospitals around the country. Policy makers, starting with New York State, have begun mandating hospital adoption and adherence to these protocols, and now the Centers for Medicare and Medicaid Services is considering adopting a metric for protocol adherence that was recently ratified by the National Quality Forum.
But according to Chanu Rhee, MD, Michael Klompas, MD, MPH and colleague, while the increasing attention to sepsis care is a positive step, mandated policies must be tempered by two limitations: (1) that we still need to learn the best way to diagnose and treat this condition and (2) that we don’t yet have reliable surveillance tools for measuring sepsis incidence. Without accurate diagnostic tools, sepsis mandates can be risky because the nonspecific symptoms of sepsis may result in indiscriminate prescribing of antibiotics, overuse of invasive catheters and fluids, and unnecessary utilization of scarce ICU resources. Without accurate surveillance methods, benchmarking hospitals’ performance on sepsis care may be too easily influenced by variability and changing practices in how sepsis is diagnosed and reported.
To read more details in the full NEJM Perspective, click here.