Evidence Underpinning the Centers for Medicare &amp; Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1)
Authors: Dominique J. Pepper, Charles Natanson, Peter Q. Eichacker
Journal: Annals of Internal Medicine (2018)

Letters17 April 2018Evidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1)Dominique J. Pepper, MBChB, MD, Charles Natanson, MD, and Peter Q. Eichacker, MDDominique J. Pepper, MBChB, MDNational Institutes of Health, Bethesda, Maryland (D.J.P., C.N., P.Q.E.), Charles Natanson, MDNational Institutes of Health, Bethesda, Maryland (D.J.P., C.N., P.Q.E.), and Peter Q. Eichacker, MDNational Institutes of Health, Bethesda, Maryland (D.J.P., C.N., P.Q.E.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0140 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:In response to Dr. Townsend and colleagues' comment, our review has been corrected to clarify both that use of interventions in SEP-1 does not yet directly affect hospital reimbursement or accreditation and which versions of SEP-1 and CMS evidence criteria we used in our review. These revisions do not affect the review's core assertion that, after evaluating the scientific evidence underpinning SEP-1, we conclude that SEP-1 lacks high- or moderate-level evidence to support its hemodynamic interventions.We disagree that SEP-1 is a simple, government-mandated reporting mechanism. As an official performance measure, it is but the first step on ...References1. 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Accessed at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Hospital-Value-Based-Purchasing-.html on 1 March 2018. Google Scholar5. Faust JS, Weingart SD. The past, present, and future of the centers for medicare and medicaid services quality measure SEP-1: the early management bundle for severe sepsis/septic shock. Emerg Med Clin North Am. 2017;35:219-31. [PMID: 27908335] doi:10.1016/j.emc.2016.09.006 CrossrefMedlineGoogle Scholar6. Johns Hopkins Medicine. The sepsis core measure. Medicine Matters Blog. 3 March 2016. Accessed at https://medicine-matters.blogs.hopkinsmedicine.org/2016/03/the-sepsis-core-measure on 1 March 2018. Google Scholar7. The Joint Commission. Specifications manual for national hospital inpatient quality measures. 2018. Accessed at www.jointcommission.org/specifications_manual_for_national_hospital_inpatient_quality_measures.aspx on 1 March 2018. Google Scholar8. Jaswal DS, Natanson C, Eichacker PQ. Endorsing performance measures is a matter of trust. BMJ. 2018;360:k703. [PMID: 29475872] doi:10.1136/bmj.k703 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Institutes of Health, Bethesda, Maryland (D.J.P., C.N., P.Q.E.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2947.This article was published at Annals.org on 15 March 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1) Dominique J. Pepper , Dharmvir Jaswal , Junfeng Sun , Judith Welsh , Charles Natanson , and Peter Q. Eichacker Correction: Severe Sepsis and Septic Shock Management BundleEvidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1) Sean R. Townsend , Lemeneh Tefera , and Emanuel P. Rivers Metrics Cited byOptimizing the Implementation of Clinical Predictive Models to Minimize National Costs: Sepsis Case StudyLebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)European Resuscitation Council Guidelines 2021: Paediatric Life SupportAssessment of a Cellular Host Response Test as a Sepsis Diagnostic for Those With Suspected Infection in the Emergency DepartmentIncreasing Quality, Not Costs*A Multimodal Sepsis Quality-Improvement Initiative Including 24/7 Screening and a Dedicated Sepsis Response Team-Reduced Readmissions and MortalityCorrection: Severe Sepsis and Septic Shock Management Bundle 17 April 2018Volume 168, Issue 8Page: 610-612KeywordsHemodynamicsInterquartile rangeMedicareOxygenPerformance measuresRandomized trialsResearch designSepsisShockVasopressors ePublished: 6 March 2020 Issue Published: 17 April 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. 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