Friday, February 22, 2019

Sep 1: thumbs up or thumbs down?

A piece in Today's Hospitalist covers some of the ins and outs of CMS's most complicated core measure yet. we’ve yet to realize the unintended consequences. It’s based on data from a survey (and the subjects were “quality officers” and others predisposed to drink the performance kool aid) the results of which suggested that the measure is perceived to be beneficial. But it restricts clinical judgment and is based on ideas deemed out of date by many.

After going through a long list of flaws and potential harms of the measure here's how the Today’s Hospitalist piece concludes (emphasis mine):

“While some people’s instinct is to just reject” the measure, Dr. Barbash says he draws a different conclusion from his research. “We have a professional obligation to try to make it better in ways that ultimately help us provide the best care for patients.” While SEP-1 “has gotten us to start paying attention to the most important killer of hospitalized patients,” he believes a revised sepsis measure could do better.

He's asserting that it took a CMS core measure to even get us to start paying attention to sepsis. Where has he been the last 15 years?

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