Authors: Berenholtz, Sean M.; Pronovost, Peter J.; Ngo, Koni; Barie, Philip S.; Hitt, John; Kuti, Joseph L.; Septimus, Edward; Lawler, Nancy; Schilling, Lisa; Dorman, Todd; The Core Sepsis Measurement Team,

Source: Joint Commission Journal on Quality and Patient Safety, Volume 33, Number 9, September 2007 , pp. 559-568(10)

Publisher: Joint Commission Resources

Abstract:

Background: Sepsis is associated with increased morbidity, mortality, and costs of care. Although several therapies improve outcomes in patients with sepsis, rigorously developed measures to evaluate quality of sepsis care in the intensive care unit (ICU) are lacking.

Methods: To select an initial set of candidate measures, in 2003-2004 an interdisciplinary panel reviewed the literature and used a modified nominal group technique to identify interventions that improve outcomes of patients with sepsis in the ICU. Design specifications or explicit definitions for each candidate measure were developed.

Results: Ten potential measures were identified: vancomycin administration, time to vancomycin initiation, broad-spectrum antibiotic administration, time to broad-spectrum antibiotic initiation, blood culture collection, steroid administration, corticotropin stimulation test administration, activated protein C eligibility assessment, activated protein C administration, and vancomycin discontinuation.

Discussion: The identification of potential measures of quality of care for patients with sepsis can help care-givers to focus on evidence-based interventions that improve mortality and to evaluate their current performance. Further work is needed to evaluate the feasibility and validity of the measures.

Document Type: Research article

Publication date: 2007-09-01

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• Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.
  
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