M

ore than a decade ago, a young man showed up in the emergency department of the hospital where I worked in St. Paul, Minnesota. He had been on a hunting trip with friends when he started to behave strangely and complained of a sore throat. As his symptoms worsened and he became confused, his friends sensed something was wrong and rushed him from the woods to the hospital.

At first, it wasn’t clear if his high fever and symptoms were tied to a terrible case of strep throat or to something worse. But as his heart rate sped up and he became increasingly confused, eventually losing consciousness and the ability to breathe, we knew it was sepsis.

To treat this often-deadly condition, we put him on antibiotics, fluids, a ventilator to control his breathing, and adrenaline-like medications. Though it took him days to regain consciousness and breathe on his own, he eventually made a full recovery.

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Not all sepsis stories have a happy ending — in fact, of the 1.5 million Americans who develop sepsis each year, nearly 260,000 die from it.

Sepsis is the body’s overwhelming response to an infection. It can occur in virtually anyone with an infection, though it’s more likely to appear among elderly individuals and those who have undergone surgery. While health care providers are broadly aware of the condition and its symptoms, it can be difficult to identify early.

Sepsis can start off with a fever and increased heart rate, but can quickly become more serious as it causes difficulty breathing, changes in skin color, and organ failure. The initial treatment for sepsis, antibiotics and intravenous fluids, is deceptively simple and widely accepted among health professionals. The big treatment challenge is time, because with every hour that passes during which the patient isn’t treated, the prognosis worsens significantly.

To help ensure timely, consistent, and high-quality care for sepsis patients, the Centers for Medicare and Medicaid Services adopted in 2015 the Sepsis National Hospital Inpatient Quality Measure (SEP-1) that had been developed by the National Quality Forum. This metric assesses hospitals’ timely treatment of sepsis, which costs more than $27 billion annually. Going a step further, the Centers for Medicare and Medicaid Services on Wednesday began publishing sepsis treatment statistics for all hospitals across the country. This is the first time that this information is being made publicly available.

To find your hospital’s score, visit Medicare’s Hospital Compare website. Type in your ZIP code, then the hospital’s name. On the hospital’s page, click the “Timely & effective care” tab and then click the “Sepsis care” drop-down menu. You can then see the hospital’s score and compare it to state and national averages.

A high score shows that a hospital has been following sepsis treatment protocols and that, when patients develop sepsis, they are generally treated properly. A low score indicates poor sepsis care.

Hospital Compare currently includes SEP-1 scores for the first nine months of 2017. The first full year of data will follow in October.

Looking at Hospital Compare sepsis scores for states, the District of Columbia, and Puerto Rico, some are clearly doing better than others.

Top 10

Bottom 10

Location

Score Location

Score

Hawaii

68 Puerto Rico

11

Idaho

62 District of Columbia

35

New Hampshire

61 Delaware

36

Florida

56 Rhode Island

40

New Jersey

56 Washington

42

Wyoming

56 Indiana

43

Colorado

55 Connecticut

43

Maryland

55 Minnesota

44

Montana

55 Nevada

44

South Carolina

54 Missouri

44

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Patients today tend to have options when seeking hospital care. Those aware of the dangers of sepsis may well look for hospitals with more favorable sepsis ratings. This isn’t a Yelp review or blog post; it’s an official report from the Centers for Medicare and Medicaid Services. Since hospitals no longer have the option to conceal this information, it pushes the issues of transparency and accountability to the surface, which are absolute necessities to drive change.

Hospitals are working to combat sepsis: employing special training to educate staff on the warning signs of sepsis; mandating the use of protocols; and deploying electronic surveillance and alerting systems. Many such systems frequently fire false alerts. Over time, staff members tend to ignore these alerts, due to what is known as alert fatigue. A highly accurate and effective alerting system can be a game-changer in saving lives.

Institutions need to look closely at their sepsis performance and it will be a sobering moment for some. But this new trove of data has the potential to be historic in combating the deadliest condition in U.S. hospitals. July 2018 could be the dawn of a new era of sepsis treatment, one in which more patients will be as fortunate as the young hunter I cared for and make full recoveries from this deadly and fast-moving condition.

Steve Claypool, M.D., is the medical director at Wolters Kluwer Health, which makes a software product for sepsis surveillance.

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  • I did as suggested and tried to look up the data on the Medicare website. What I found was dismaying. Everything I know about the hospital from first hand experience is entered incorrectly on the site. The website states the hospital doesn’t have an ER. It does–a large, well-organized one. The website states the hospital can’t follow patient data from visit to visit. Wrong again. Everything is computerized and has been for years. It makes me question the veracity of everything else on the site. In any case, “results not available for this reporting period” is the usual recorded result across the board, regardless of what condition I looked at.

    • They are Gas lighting us all. The data they collect is only the data that does not interfere with Industry Profits. Articles like this make it appear there are credible people working on it, or that they are actually collecting meaningful data, when they are not. International Organizations are critical of US Healthcare, but we won’t see that in any these publications.

  • These numbers are not the real picture, there are many ways to game the reporting system which is voluntary, by design. Hospital can send certain people of to Medicaid nursing homes, patient dumping. There are no real death reporting requirements, so the facts get buried along with the mistakes. It is just a matter of time before there is something uncontrollable, our profit driven and corrupt healthcare system, is not prepared for anything on this scale.
    A local religious non profit hospital with a high rate of infection, had one of their local journalists, turn attention elsewhere. He dissembled any concerns over infection, with an advertisement for a useless piece of equipment from a major manufacturer. Serious public health concerns, become Advertorial content. We are in post science and post fact America, Super-bugs and Antibiotic resistant infections , are not too concerning, unless they interfere with profitability. The Cause of Death can be attributed to whatever they want. In my community a person with a post surgical infection, saves the company money by going to an Acupuncturist. Reports of post surgical pain due to infection, are easily explained away, especially if the patient is female, brown and low income. When they are denied readmit to the hospital they turn in desperation to alternative healers. The hospital can send older patients home to “Die with Dignity” the family unaware of the infection.

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