Hello, I have been pulling quarterly reports for physicians on Sepsis, 
Severe Sepsis and Septic Shock to provide feedback to them on number of cases, 
length of stay, patients who expired, EGDT and orders sets used or not, etc... 
I have been pulling the data based on ICD-9 codes 995.91, 995.92 and 785.52. I 
have received some push-back for not using the DRG versus the ICD-9 code. What 
is the benefit of looking at patients based on the DRG versus the ICD-9 code or 
is there a better way to look at it; I am interested in what others are doing 
and for any suggestions for ways to improve.

    When I started I was seeing many patients who met the criteria for Severe 
Sepsis ending up in the Sepsis (995.91) category with higher mortality in that 
group. In working with this and physician documentation, I was able to show 
great improvement for the past two quarters. I have also been looking at these 
patients to see if they were coded as present on admission (POA), looking at 
cases that presented to the emergency room to see if they were 
screened-identified in the ED, treatment started, time zero, lactate drawn and 
value, IV fluids, antibiotics given, etc...


Thank You
Robert Hattabaugh MSN, RN, ACNS-BC, CMSRN

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