I’m curious what criteria most organizations are using to query for sepsis (sepsis 1 vs sepsis 3 vs other). Our organization doesn’t use any clear consistent criteria: it's based more off our subjective interpretation of whether we think the patient “appears septic.” This also includes sending clinical validation queries on patients with a documented diagnosis of sepsis that meet sepsis 1 or 3 criteria. While I understand the importance of using our clinical knowledge to evaluate cases, I think requiring subjective interpretation can be a dangerous practice. I personally prefer (and think best practice is ) to use primarily objective, quantifiable criteria when querying for sepsis, particularly when questioning the validity of a documented diagnosis by a provider that has actually physically evaluated the patient as well. With subjective interpretation, I suspect you will see much more variability between CDI specialists and are more likely to create confusion and frustration from the providers. What are other organizations doing?
I think your executives, (medical staff, HIM, CDI, Compliance) need to adopt 'a' consensus definition for sepsis - one which would be widely accepted. Lacking such definitions for sepsis (or many other conditions) the reviews performed by a CDI team will be inconsistent and subjective.
Our organization has not yet adopted one criteria for sepsis. We (CDI department) are using sepsis 3 criteria for query indicators. However, if a provider documents sepsis and lists their clinical criteria, we do not send clinical validation queries on those, even if they do not meet sepsis 3 as they have clearly documented their rationale behind their diagnosis.
We use Sepsis 1 and are transitioning to Sepsis 3 with one change - we also have a point for elevated lactate. We found it is much easier to deal with insurance companies when we have a institutional diagnosis for sepsis
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We use Sepsis 1 and are transitioning to Sepsis 3 with one change - we also have a point for elevated lactate. We found it is much easier to deal with insurance companies when we have a institutional diagnosis for sepsis