Hospital Perceptions of Medicare's Sepsis Quality Reporting Initiative
Hospital Perceptions of Medicare's Sepsis Quality Reporting Initiative
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DOI：
10.12788/jhm.2929
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发表时间：
2017-12-01
影响因子：
2.6
通讯作者：
Kahn, Jeremy M.
中科院分区：
文献类型：
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作者：
Barbash, Ian J.;Rak, Kimberly J.;Kahn, Jeremy M.
背景技术背景：2015年10月，医疗保险和医疗补助服务中心（CMS）实施了脓毒症CMS核心措施（SEP-1）计划，要求医院报告脓毒症患者的护理质量数据。目的：我们试图了解医院对SEP-1计划的看法和反应。设计：对医院质量官员进行半结构化访谈的主题内容分析。短期停留的分层随机抽样，非联邦，一般急性护理医院在美国。主题：医院质量官员，包括护士和医生。干预：无。测量：我们完成了29次采访前达到内容饱和。结果：医院报告了针对SEP-1的各种行动，包括收集数据、改善脓毒症诊断和治疗的新努力，并管理临床医生对SEP-1的态度。这些努力通常需要专门的资源来满足该计划对治疗和记录的要求，这些要求被认为是复杂的，并且与以患者为中心的结果不一致。大多数受访者认为SEP-1可能改善脓毒症结局。与此同时，他们描述了可以提高其有效性的具体变化，包括允许医院专注于与改善患者结局最直接相关的治疗过程，并更好地将该措施的脓毒症定义与当前的临床definitions.CONCLUSIONS：医院正在响应SEP-1计划在多个领域，并以一贯需要专用资源的方式。医院有兴趣进一步修订该计划，以减轻报告要求的负担，并帮助他们优化质量改进工作的投资效果。(c)2017医院医学学会
BACKGROUND: In October 2015, the Centers for Medicare and Medicaid Services (CMS) implemented the Sepsis CMS Core Measure (SEP-1) program, requiring hospitals to report data on the quality of care for their patients with sepsis.OBJECTIVE: We sought to understand hospital perceptions of and responses to the SEP-1 program.DESIGN: A thematic content analysis of semistructured interviews with hospital quality officials.SETTING: A stratified random sample of short-stay, nonfederal, general acute care hospitals in the United States.SUBJECTS: Hospital quality officers, including nurses and physicians.INTERVENTION: None.MEASUREMENTS: We completed 29 interviews before reaching content saturation.RESULTS: Hospitals reported a variety of actions in response to SEP-1, including new efforts to collect data, improve sepsis diagnosis and treatment, and manage clinicians' attitudes toward SEP-1. These efforts frequently required dedicated resources to meet the program's requirements for treatment and documentation, which were thought to be complex and not consistently linked to patient-centered outcomes. Most respondents felt that SEP-1 was likely to improve sepsis outcomes. At the same time, they described specific changes that could improve its effectiveness, including allowing hospitals to focus on the treatment processes most directly associated with improved patient outcomes and better aligning the measure's sepsis definitions with current clinical definitions.CONCLUSIONS: Hospitals are responding to the SEP-1 program across a number of domains and in ways that consistently require dedicated resources. Hospitals are interested in further revisions to the program to alleviate the burden of the reporting requirements and help them optimize the effectiveness of their investments in quality-improvement efforts. (c) 2017 Society of Hospital Medicine