SIRS indicators

lsipos@monument.health

Good morning. Currently we are working on changing our SIRS/SEPSIS query to reflect upcoming changes in I-10 for these diagnosis. On our current query, we have the SIRS indicators with the temp of 38.0. Our SEPSIS coordinator informed us last week that starting June 15 the temperature for our screening tools for our sepsis initiative through the ED and with sepsis screening tools (for the floors) was being changed from 38.0 to 38.3 per recommendations from the new CMS guidelines for reporting sepsis.

Does anyone else currently use 38.0 as was suggested years ago by our consultant (from Merck), or are you changing to reflect the trend for the higher temp??

TIA

Juli
Juli Bovard RN CCDS
Certified Clinical Documentation Specialist
Clinical Effectiveness/Clinical Quality
Rapid City Regional Hospital
755-8426 (work)
786-2677 (cell)
"No Limit to Better......"
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deanne_wilk

We are going with the new national guidelines for "Surviving Sepsis" campaign. It is more for severe sepsis and septic shock; however. We currently use 38.

http://www.survivingsepsis.org/Resources/Pages/default.aspx



Deanne Wilk, BSN, RN, CCDS, CCS
AHIMA approved ICD-10-CM/PCS Trainer

Clinical Documentation Improvement and Inpatient Coding Manager
HIMS Department
Good Samaritan Health System
4th & Walnut Sts
Lebanon, PA 17042
dwilk@gshleb.org

Phone: 717-270-7582
Cell: 717-580-1436

lsipos@monument.health

Thanks Deanne!

From: CDI Talk [mailto:cdi_talk@hcprotalk.com]
Sent: Wednesday, June 24, 2015 8:30 AM
To: Bovard, Juli
Subject: RE:[cdi_talk] SIRS indicators

We are going with the new national guidelines for "Surviving Sepsis" campaign. It is more for severe sepsis and septic shock; however. We currently use 38.

http://www.survivingsepsis.org/Resources/Pages/default.aspx



Deanne Wilk, BSN, RN, CCDS, CCS
AHIMA approved ICD-10-CM/PCS Trainer

Clinical Documentation Improvement and Inpatient Coding Manager
HIMS Department
Good Samaritan Health System
4th & Walnut Sts
Lebanon, PA 17042
dwilk@gshleb.org

Phone: 717-270-7582
Cell: 717-580-1436

tina.brooks

This may take further investigation but I think the CMS guidelines and studies are indicating a need to differentiate between Sepsis and Severe Sepsis for treatment as well as reporting quality measures for 2017. I don't think we need to throw out the 38.0 as that still is an indicator of Sepsis and early recognition is still vital. Thank you for the link to Surviving Sepsis.

Tina Brooks, RN, CCDS, CRCR
Clinical Documentation Specialist
NCN Revenue Integrity

evanspx@sutterhealth.org

Could someone please post a link to the CMS guidelines for reporting sepsis?



I hope this won't devolve into a situation whereby we are denied reporting sepsis in patients that are clearly stated as having sepsis, based upon the judgement of the clinical staff, only to have someone off-site 'deny' the diagnosis because the temperature did not meet the "CMS" Criteria? As we all know, there are many, many variables impacting an individual's physiological response to Sepsis.

I am obviously not a clinical expert on the topic, but our physicians place a lot of faith in the International Guidelines regarding Sepsis - but none in the diagnostic ability of CMS.

Paul



Paul Evans, RHIA, CCS, CCS-P, CCDS

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421

evanspx@sutterhealth.org

Snook@fmchealth.org

We have a new Core Measure rolling out on 10/1/15-yes the same day as ICD 10 for sepsis, severe sepsis and septic shock. It will cast a wide net for Sepsis documentation , coding and capturing as the criteria are going to change. New query to be developed and consideration for additional CDI staff-(one maybe). Scrambling are we. Notification from CMS was in a six month time frame!

Mary L. Snook RN-BC
Clinical Documentation Improvement Specialist
Fairfield Medical Center
740-689-4443

Unknown

I have a question please? Under whose authority is the Sepsis criteria going to change? Where do we look to find these new criteria that are supposed to change due to it being a core measure? Thanks
Jamie

Jamie Dugan RN, CCDS
Clinical Documentation Improvement Specialist
3563 Philips Highway, Suite #106
Jacksonville, Florida 32207
Office: 904-202-4345

Snook@fmchealth.org

Our quality department brought it to our Sepsis meetings. It is going to be a bit of a rush to pull it all together but we will. We had already had been working on our Sepsis mortality rates, treatment guidelines etc for three years working with Six Sigma. So we already had a lot of data in place.

Mary L. Snook RN-BC
Clinical Documentation Improvement Specialist
Fairfield Medical Center
740-689-4443

Snook@fmchealth.org

CMS

Mary L. Snook RN-BC
Clinical Documentation Improvement Specialist
Fairfield Medical Center
740-689-4443

cvfearns@gmail.com

I'm not sure if this is what you are looking for but the core measure guidelines are on qualitynet.org. If you go to the inpatient specifications manual and then go to the version that starts in October 2015, you should find it.
Catherine V. Fearns BSN, RN, CCM
Clinical Documentation Specialist
Chesapeake Regional Medical Center
757-312-5154

cvfearns@gmail.com

Here's the link- https://www.qualitynet.org/

Hope this helps

Catherine V. Fearns BSN, RN, CCM
Clinical Documentation Specialist
Chesapeake Regional Medical Center
757-312-5154

evanspx@sutterhealth.org

Are we referring to authority to issue quality measures for patients w/ Sepsis and/or 'authority' to mandate when the condition is diagnosed by a clinician?


As far as institution of Core Measures under the Pay For Performance Program, CMS has authority to mandate required PROCESS measures for patients w/ Sepsis. To my knowledge, CMS, nor any other 3rd party, does not have authority to mandate how and when the condition is recognized or diagnosed.

Paul Evans, RHIA, CCS, CCS-P, CCDS

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421

evanspx@sutterhealth.org

katysuegood@gmail.com

This is my understanding too Paul. We are under the quality dept at our facility and have had several recent discussions with QMRN's about the new sepsis core measures and how we can work together to prevent fallouts. Never have we been discussing changing in clinical definitions of sepsis. We are focusing on how we identify patients to ensure that proper treatment/management is provided to meet core measure standards.

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404