TY - JOUR
T1 - Developing quality measures for sepsis care in the ICU
AU - Berenholtz, Sean M.
AU - Pronovost, Peter J.
AU - Ngo, Koni
AU - Barie, Philip S.
AU - Hitt, John
AU - Kuti, Joseph L.
AU - Septimus, Edward
AU - Lawler, Nancy
AU - Schilling, Lisa
AU - Dorman, Todd
N1 - Funding Information:
We have identified several potential measures of the quality of care for patients with severe sepsis and septic shock in the ICU. These measures require further evaluation, and their value will be determined by our ability to evaluate our current performance and to implement interventions designed to decrease the morbidity, mortality, and costs of sepsis care in the ICU. The project described in this article was supported by a grant from the VHA Health Foundation, Irving, Texas. VHA Health Foundation received financial support from Eli Lilly, Inc., for the conduct of this project. Representatives from Eli Lilly, Inc., did not participate in the conduct or reporting of this project. The authors and the following institutions and investigators participated in this project: Barnes Jewish Hospital: Theresa Garrison; Johns Hopkins University Bloomberg School of Public Health: William J. Ward, Jr.; The Joint Commission: Mary Fialkowski, Linda Hanold, Jerod Loeb, Sharon Sprenger; VHA Health Foundation: Linda DeWolf; VHA, Inc.: Leona Brandwene, Robert E. Davis, Pat Houghton, Peggy Kjelgaard, Firouzeh Manuchehri-Kashani, Marla McCann, Nancy Menary, Janice Murray, Colleen Risk, Kenneth Smithson. The authors also thank Tzipora Sofare, M.A., for her editorial assistance in preparing this manuscript.
PY - 2007/9
Y1 - 2007/9
N2 - 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 caregivers 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.
AB - 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 caregivers 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.
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U2 - 10.1016/S1553-7250(07)33060-2
DO - 10.1016/S1553-7250(07)33060-2
M3 - Article
C2 - 17915530
AN - SCOPUS:34548761594
SN - 1553-7250
VL - 33
SP - 559
EP - 568
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 9
ER -