Time of presentation is defined in the originating NQF documents. If asked to clarify my belief is CMS will resort to the NQF definition which states:
“time of presentation” is defined as the time of triage in the Emergency Department or, if presenting from another care venue, from the earliest chart annotation consistent with all elements severe sepsis or septic shock ascertained through chart review." Sean R. Townsend, MD Vice President of Quality & Safety California Pacific Medical Center 2330 Clay Street #301 San Francisco, CA 94115 [email protected]<mailto:[email protected]> 415-600-5770 office 415-600-1541 fax On Apr 6, 2015, at 7:36 AM, Ryan Arnold <[email protected]<mailto:[email protected]>> wrote: Sean, There is no mention of ED triage time in the new CMS guidelines in my reading. Do you have a specific reference you found within CMS that refers to ED triage time? The guidelines mention “presentation” of severe sepsis or septic shock, not arrival or triage time. The only time based reference they use is whether the patient has been hospitalized for ≤ 120 days. A patient who does not meet criteria for severe sepsis at ED triage does not have severe sepsis at ED triage, and would thus not meet the criteria for the CMS measure until they meet the clinical criteria for severe sepsis, whether it is in the ED or inpatient days later. Ryan ________________________________ Ryan Arnold, MD Research Director, Department of Emergency Medicine Clinical Investigator, Value Institute Christiana Care Health System Newark, DE On Apr 3, 2015, at 9:23 PM, Townsend, Sean, M.D. <[email protected]<mailto:[email protected]>> wrote: Jennifer, your interpretation is correct. For patients presenting to the ED, triage time is time zero under the CMS measure. Sean R. Townsend, M.D. Vice President of Quality & Safety California Pacific Medical Center 2330 Clay Street, #301 San Francisco, CA 94115 email [email protected]<mailto:[email protected]> office (415) 600-5770 fax (415) 600-1541 ________________________________ From: Sepsisgroups [[email protected]<mailto:[email protected]>] On Behalf Of Jennifer L Halligan [SJGH] [[email protected]<mailto:[email protected]>] Sent: Thursday, April 02, 2015 8:44 AM To: [email protected]<mailto:[email protected]> Subject: [Sepsis Groups] CMS Abstraction for Severe Sepsis/Septic Shock PRESENTATION TIME Question to the group. I have been and currently still am abstracting TRIAGE TIME for “time zero”. With the release of the new measure specification manual/abstraction guidelines I want to clarify that I will still abstract TRIAGE time as severe sepsis/septic shock PRESENTATION TIME even though ALL the criterion may NOT be met yet at the time of triage, i.e. for severe sepsis -1) documentation of suspected source of infection, 2) 2 SIRS criteria, and 3) organ dysfunction? Thank you, Jennifer Jennifer Halligan, RN Quality Review Nurse San Joaquin General Hospital Tel: 209-468-7471 Fax: 209-468-7011 <image001.gif>_______________________________________________ Sepsisgroups mailing list [email protected]<mailto:[email protected]> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
