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<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496">Hi Claudia; <o:p>
</o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496">At Sutter Health we report severe sepsis and septic shock combined and separately.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496">We show data as an aggregate for our combined 24 acute care facilities and for each discreet entity.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496">We do NOT include “simple” sepsis patients and we do not use the new sepsis definitions.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496"><o:p> </o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">Thanks,
<o:p></o:p></span></b></p>
<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#00A19C"><o:p> </o:p></span></b></p>
<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#00A19C">MARY ANN BARNES-DALY
</span></b><b><span style="font-size:8.0pt;font-family:"Arial",sans-serif;color:#00A19C">MS RN CCRN DC</span></b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#365F91">
</span><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1D1B11">|</span><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#365F91">
</span><b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:gray">Clinical Performance Improvement Consultant</span></b><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#365F91"><o:p></o:p></span></p>
<p class="MsoNormal"><b><i><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">Quality & Clinical Effectiveness Team
</span></i></b><b><i><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#E36C0A">|</span></i></b><i><span style="font-size:10.0pt;color:#1F497D">
</span></i><b><i><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">Office of Patient Experience</span></i></b><b><i><span lang="EN" style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D"><o:p></o:p></span></i></b></p>
<p class="MsoNormal"><b><i><span lang="EN" style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">Sutter Health -</span></i></b><i><span lang="EN" style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">2200 River Plaza Drive, Sacramento,
CA 95833<b><o:p></o:p></b></span></i></p>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D">Mobile 916.200.5604</span><b><span style="font-family:"Arial",sans-serif;color:#00A19C">|
<a href="mailto:barnesm4@sutterhealth.org">barnesm4@sutterhealth.org</a> <o:p></o:p></span></b></p>
<p class="MsoNormal"><i><span style="color:#1F497D"><o:p> </o:p></span></i></p>
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<p class="MsoNormal" align="center" style="text-align:center"><b><i><span style="font-size:10.5pt;font-family:"Helvetica",sans-serif;color:#333333">All changes, even the most longed for, have their melancholy; for what we leave behind us is a part of ourselves.<o:p></o:p></span></i></b></p>
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<p class="MsoNormal" align="center" style="text-align:center"><span style="font-size:10.0pt;font-family:"Helvetica",sans-serif;color:#555555">Anatole France<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#1F497D"><img border="0" width="133" height="133" id="_x0000_i1026" src="cid:image002.jpg@01D3C021.ED61F4F0" alt="https://newsplus.sutterhealth.org/peninsula-coastal/files/2017/04/SH_Pride_Plus400-002-177x177.gif"></span><span style="color:#2F5496"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:14.0pt;color:#2F5496"><o:p> </o:p></span></p>
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<p class="MsoNormal"><b>From:</b> Sepsisgroups [mailto:sepsisgroups-bounces@lists.sepsisgroups.org]
<b>On Behalf Of </b>Orth, Claudia<br>
<b>Sent:</b> Friday, March 16, 2018 1:35 PM<br>
<b>To:</b> sepsisgroups@lists.sepsisgroups.org<br>
<b>Subject:</b> [**External**] [Sepsis Groups] "Sepsis" Mortality vs. "Severe Sepsis" & Septic Shock Mortality<o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p style="margin-top:0in"><strong><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:maroon">WARNING:
</span></strong><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#666666">This email originated outside of the Sutter Health email system!<br>
</span><strong><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:maroon">DO NOT CLICK</span></strong><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#666666"> links if the sender is unknown and never provide your User ID or
Password. <o:p></o:p></span></p>
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<p class="MsoNormal" style="margin-bottom:12.0pt"><span style="font-size:12.0pt;font-family:"Times New Roman",serif"><o:p> </o:p></span></p>
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<p class="MsoNormal">Good Afternoon, <o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">I am hoping to gain insight into how most other facilities are reporting their mortality to senior leadership, the board, etc. Depending on where we get our data from the mortality obviously varies greatly and it is not always clear what
definitions or specifications are actually being used to garner the data! <o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">I would be incredibly grateful to anyone willing to answer the following questions so I can make recommendations moving forward for our facility on how to best standardize and develop a “source of truth”:
<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>Are you using “Overall Sepsis mortality” that includes all of the ICD-10 CM codes identified to fit per the CMS SEP-1 measure
<a href="file:///C:\Users\corth1\Downloads\Appendix_A.1_v5_3a%20(1).pdf">file:///C:/Users/corth1/Downloads/Appendix_A.1_v5_3a%20(1).pdf</a> ?<o:p></o:p></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l0 level1 lfo2"><![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>Or are you only reporting on “Severe Sepsis and Septic Shock” mortality which would be R6520 & R6521 similar to the grid below?<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><b><span style="color:black">Measure Name: <o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Severe Sepsis/Septic Shock Mortality Rate<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Numerator:<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Patients with discharge status of expired<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Denominator:<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Patients with principle or secondary diagnosis of severe sepsis or septic shock<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Harm Prevented:<o:p></o:p></span></b></p>
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<td width="506" style="width:379.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt">
<p class="MsoNormal"><b><span style="color:black">Sepsis Death<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Multiplier:<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">100<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Y-axis title:<o:p></o:p></span></b></p>
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<p class="MsoNormal"><b><span style="color:black">Sepsis mortality/100 sepsis diagnoses<o:p></o:p></span></b></p>
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<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l1 level1 lfo4"><![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>Or are you using something entirely different? <span style="font-family:Wingdings">
J</span><o:p></o:p></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l1 level1 lfo4"><![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>Are you reporting a rate, a percentage, total number of deaths, ???<o:p></o:p></p>
<p class="MsoListParagraph" style="text-indent:-.25in;mso-list:l1 level1 lfo4"><![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]>Also is the mortality risk adjusted or not? <o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Thank you in advance for your time and consideration to share!
<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Sincerely,<o:p></o:p></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><b><span style="color:#017DC3">Claudia Orth, BSN, RN, CCRN-K</span><i><span style="color:#0070C0">
</span></i><span style="color:#0070C0"><o:p></o:p></span></b></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black">Sepsis Coordinator<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black">Clinical Quality<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black"><o:p> </o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black">1105 Sixth St.
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black;background:white">Traverse City, MI 49684</span><span style="color:black"><br>
(231) 935-5692<b> </b>voice<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black">(231) 935-6629 fax<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black">(231) 318-0394 pager<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:11.0pt;mso-line-height-rule:exactly"><span style="color:black"><a href="mailto:corth1@mhc.net">corth1@mhc.net</a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><img border="0" width="176" height="36" id="Picture_x0020_1" src="cid:image003.jpg@01D3C021.ED61F4F0" alt="MMC_Blue-SigSize96dpi"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:8.0pt;color:black"><a href="https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttp-3A__www.munsonhealthcare.org_mmc%26d%3DDwMFAg%26c%3DNjMSpGk2_ZA7ZXEWULsqPkmhl_68_j_HpnUZ-YvUJ78%26r%3DpSDnJFSP19PcIPYCugMuAA6W8De3hsh8Rlv69n9ifMnjcpLdmRTubxkg38lTVlXD%26m%3D9ExZVPYmt6hp8oVk2M4jHEj_diAqWpHEp9bt7Y4uvq4%26s%3DtntSET4pB8xZCYLLcMoVK15ecy1eWvZxSQY0TMB7vHE%26e%3D&data=02%7C01%7Cbarnesm4%40sutterhealth.org%7C2f2c28ecc04e48cc594708d58e6c2f9f%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636571517672020756&sdata=4GwKo15E9XhCt5y1kuVzlI%2BhZf0EHSD6Kksy%2F7089EA%3D&reserved=0"><span style="color:black">Website</span></a>
I <a href="https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttp-3A__www.munsonhealthcare.org_physician%26d%3DDwMFAg%26c%3DNjMSpGk2_ZA7ZXEWULsqPkmhl_68_j_HpnUZ-YvUJ78%26r%3DpSDnJFSP19PcIPYCugMuAA6W8De3hsh8Rlv69n9ifMnjcpLdmRTubxkg38lTVlXD%26m%3D9ExZVPYmt6hp8oVk2M4jHEj_diAqWpHEp9bt7Y4uvq4%26s%3D3qLvgS2Qxw1KoaweXc8zC6XMpONCC4w97NWGnDCKQFI%26e%3D&data=02%7C01%7Cbarnesm4%40sutterhealth.org%7C2f2c28ecc04e48cc594708d58e6c2f9f%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636571517672020756&sdata=SxyR6tZRJEN5A7FECzy2%2Fn9Vz6N3FO7NkmSG%2BqzVXsU%3D&reserved=0"><span style="color:black">Find
a Physician</span></a> I <a href="https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttp-3A__www.munsonhealthcare.org_maps%26d%3DDwMFAg%26c%3DNjMSpGk2_ZA7ZXEWULsqPkmhl_68_j_HpnUZ-YvUJ78%26r%3DpSDnJFSP19PcIPYCugMuAA6W8De3hsh8Rlv69n9ifMnjcpLdmRTubxkg38lTVlXD%26m%3D9ExZVPYmt6hp8oVk2M4jHEj_diAqWpHEp9bt7Y4uvq4%26s%3DdwL6FBSy0qwbgAOaM7QMNAaL4O__w1MwE5aUVbLY2Xs%26e%3D&data=02%7C01%7Cbarnesm4%40sutterhealth.org%7C2f2c28ecc04e48cc594708d58e6c2f9f%7Caef453eadaa243e0be62818066e9ff63%7C0%7C0%7C636571517672020756&sdata=WKqVDXk3wOAWNSy7439QwQX4sMzipcWUGXZREWWXGBI%3D&reserved=0">
<span style="color:black">Maps</span></a> <o:p></o:p></span></p>
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