Policy and Quality Measures

SEPSIS Center faculty are at the forefront of shaping sepsis policy and quality metrics. Our research has identified key challenges and opportunities, including:

• Unintended consequences of mandatory process-based sepsis bundles, including promoting unnecessary broad-spectrum antibiotic use
• Variability in identifying sepsis time zero, which complicates assessments of time-sensitive care
• Factors that confound the association between sepsis bundle compliance and patient outcomes   
• Limitations and biases in the literature on time-to-antibiotics and sepsis outcomes, and how they lead to misleading conclusions regarding the association between time-to-antibiotics and mortality risk
• The lack of improvement in sepsis mortality rates following implementation of the CMS SEP-1 process measure
• Recommendations to improve sepsis quality measures by focusing on septic shock
• Advocating for shifting from rigid process-based mandates to risk-adjusted sepsis outcome measures   
• The need to use EHR clinical data rather than claims data alone to conduct risk-adjustment for sepsis outcomes   
• Leveraging hospital-onset Adult Sepsis Events to improve the breadth, efficiency, and objectivity of healthcare-associated infection surveillance

Building on this foundation, we are currently working with CDC to develop an electronic risk-adjusted sepsis outcome measure based on the Adult Sepsis Event definition. The goal is to help hospitals prioritize comprehensive, high-quality sepsis care throughout hospitalization and into post-discharge recovery.