40% compliance here at a 400 bed Community hospital in the Northwest.

-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Nielsenshultz, Yara
Sent: Thursday, January 28, 2016 11:14 AM
To: [email protected]
Subject: Re: [Sepsis Groups] Bundle compliance rates

Back in October, Dr. Townsend stated he expected a bundle compliance rate of 
30-50% (see below). Does this estimate seem congruent with your experience with 
this measure? We're seeing a wide range in compliance rates at our various 
locations. 

Thank you,

YARA NIELSENSHULTZ, RN, BSN, MS
Clinical Quality Manager
EmCare, North Division
Direct: (215) 442-5122
[email protected]
www.EmCare.com


-----Original Message-----
From: Sepsisgroups [mailto:[email protected]] On 
Behalf Of Townsend, Sean, M.D.
Sent: Saturday, October 03, 2015 1:29 AM
To: Brown, Sheree
Cc: [email protected]
Subject: Re: [Sepsis Groups] Bundle compliance rates

I expect that compliance will be very low, 30% at best for most facilities.  
Some facilities will be 15-20%.  This I also will reach 50% by 6-12 months 
experience with this metric, but getting there will not be easy.

Remember, however, CMS will report performance as a benchmark with deciles of 
performance.  If 30% is the best anyone can do, that will be P90.  That said, 
changes will be sharp -- P50 may be 27%.

All metrics accomplish one thing -- they focus facilities on improving the 
metric.  This will create conversations, meetings, collaborations, arguments, 
disagreements, settlements, etc.  And it's all good -- it means people will 
improve.  Probably with pain as well as pleasure in accomplishment.

This is a tough measure.  Very very tough.  But if you focus your energies on 
the patient and trying to work with it, it will pay off.

The first SSC paper I think is most illustrative.  Compliance went from low 
30's to mid 30's on an all or nothing basis, but mortality dropped 7%.  So, 
small gains with this measure result in tangible benefits.  It just doesn't 
"feel" good while it's happening.

See:

Levy MM, Dellinger RP, Townsend SR et al, The Surviving Sepsis Campaign: 
results of an international guideline-based performance improvement program 
targeting severe sepsis, Crit Care Med. 2010 Feb;38(2):367-74. doi: 
10.1097/CCM.0b013e3181cb0cdc.




On Oct 2, 2015, at 12:50 PM, Brown, Sheree 
<[email protected]<mailto:[email protected]>> 
wrote:

Does anyone know if CMS has established an expected minimal rate of compliance 
with the Sep-1 measure? Or if not, is there is a reported compliance rate with 
the SSC 3 hr and 6 hr bundles?

Thanks,
Sheree

Sheree Brown MSN, RN, CNL
Manager, Performance Excellence
Phone: 517 205-4209 ext. 4209
Pager:  517 534-0127
Fax:     517 788-4715
[email protected]<allegiancehealth.org>
[cid:[email protected]]

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