How ChristianaCare cut sepsis deaths to half the national average

As hospitals nationwide grapple to comply with, and push back on a Biden administration rule that aims to crack down on sepsis deaths nationally or face federal funding losses, ChristianaCare in Newark, Del., claims its sepsis mortality rates are already about half of the national average. 

The Biden administration rule was proposed in August and will require hospitals to adopt a model known as the Severe Sepsis/Septic Shock Management Bundle — also referred to as SEP-1 — by 2026 to reduce the 270,000 annual sepsis-caused deaths in the U.S. 

Sepsis is often known as the "silent killer" in hospitals, accounting for 1 in 3 hospital deals. It is notorious for being difficult to detect and identify in many patients, but ChristianaCare is ahead in its steps to reduce sepsis deaths. It has done so by treating the condition as "an equal to other illnesses such as stroke or myocardial infarction," Varadarajan Subbiah, MD, vice president of utilization management and quality at ChristianaCare stated in a Nov. 2 news release. 

The health system is also rolling out several educational resources, fact-sheets, tools and new protocols to continue its success in sepsis care. 

"To get ahead of sepsis, we’re bringing three steps — recognition, documentation and treatment — into a single, dedicated process so that it’s seamless," Dr. Subbiah said.

Streamlining efforts across these three areas and improving documentation around the condition reduces deaths, heightens staff awareness and allows patients who may be at risk to be seen more quickly, the health system claims. 

"There used to be a lot of barriers to documenting suspected sepsis, because there are so many different criteria," said Jennifer Brettler, DO, medical director of clinical documentation integrity at ChristianaCare. "Our goal is this: If you suspect sepsis, say sepsis. We can always rule it out if it’s not."

The SEP-1 model hospitals must soon adopt in order to further reduce sepsis death is based on a practice introduced in 2015 that worked as a pay-for-reporting measure. Opponents say it is not the requirement that is the issue, but how it is being implemented that could hurt hospital funding.  

But the new CMS rule turns the model into a "pay-for-performance measure" by combining it into the Hospital Value-Based Purchasing Program, a position paper from some health systems that oppose the rule asserts.

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