There remains a requirement to reassess volume status or perfusion. There is no requirement to state how that reassessment occurred or what the outcome of that reassessment was. You may literally write "perfusion reassessed." How this was done is entirely up to the clinician.
The only thing you may not do to pass this element is to not document some type of attempt to reassess the patient, however robust (or weak) the attempt may be. CMS continues to believe these high mortality patients deserve reassessment but is no longer demanding specifics of the reassessment. Although I resist the implication of the phrase "check the box," you could level that accusation. CMS believes that doctors are thoughtful and earnest and will actually perform the relevant assessment as they deem appropriate if they document having done so. ________________________________ From: Sepsisgroups <[email protected]> on behalf of Sandy Tobar <[email protected]> Sent: Monday, April 23, 2018 12:01:09 PM To: [email protected] Subject: [Sepsis Groups] Focused Exam in 5.4 requirements: [External] Sepsisgroups Digest, Vol 286, Issue 1 I was reviewing the 5.4 notes from CMS and I do not see that the focused exam is being removed. The individual element requirement is but a requirement for post fluid exam titled Repeat Volume Status and Tissue Perfusion Assessment Performed, date and time. Remains as a required element for sepsis documentation. Does anyone have additional information regarding this? Sandy Tobar MSBA, BSN, RN, CPPS Director, Clinical Transformation Sepsis, HAI & Patient Safety Trinity Health [email protected] W 734-343-1496 20555 Victor Parkway Livonia, MI 48152 trinity-health.org | Facebook | Twitter | LinkedIn -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Tuesday, April 17, 2018 4:06 PM To: [email protected] Subject: [External] Sepsisgroups Digest, Vol 286, Issue 1 Warning: This email originated from the Internet! DO NOT CLICK links if the sender is unknown, and NEVER provide your password. Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Flistinfo.cgi%2Fsepsisgroups-sepsisgroups.org&data=02%7C01%7Ctownsesr%40sutterhealth.org%7C8229f460e6ad415941ee08d5aafacb84%7Caef453eadaa243e0be62818066e9ff63%7C0%7C1%7C636602916540951633&sdata=MKjjBwO53HB1jl%2BdQ77ti8DmfOCqS5%2BhI7kUiabZ9xk%3D&reserved=0 or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Focused exam (Fiona Winterbottom) ---------------------------------------------------------------------- Message: 1 Date: Thu, 12 Apr 2018 18:12:15 +0000 From: Fiona Winterbottom <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Focused exam Message-ID: <dm5pr0601mb3719e1c6afc6f20dd8bc02e3ba...@dm5pr0601mb3719.namprd06.prod.outlook.com> Content-Type: text/plain; charset="us-ascii" Good Afternoon, I was recently at a large conference where the audience was told that the focused exam was no longer necessary. Could someone clarify this with supporting data of where this can be found? Thanks Fiona -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Monday, April 09, 2018 9:22 AM To: [email protected] Subject: Sepsisgroups Digest, Vol 285, Issue 1 THIS EMAIL IS FROM AN EXTERNAL SENDER! DO NOT click links or provide your User ID or Password if the sender is unknown. Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Flistinfo.cgi%2Fsepsisgroups-sepsisgroups.org&data=02%7C01%7Ctownsesr%40sutterhealth.org%7C8229f460e6ad415941ee08d5aafacb84%7Caef453eadaa243e0be62818066e9ff63%7C0%7C1%7C636602916540951633&sdata=MKjjBwO53HB1jl%2BdQ77ti8DmfOCqS5%2BhI7kUiabZ9xk%3D&reserved=0 or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Re: Question re: documentation of attestation that focused exam was completed (Pamela Green) 2. Re: Sepsisgroups Digest, Vol 284, Issue 3 (Pender.Linda) 3. OB patients ([email protected]) ---------------------------------------------------------------------- Message: 1 Date: Thu, 5 Apr 2018 18:21:54 +0000 From: Pamela Green <[email protected]> To: "Duane, Molly" <[email protected]>, "[email protected]" <[email protected]> Cc: Alesha Collins <[email protected]>, "Britni N. Fannin" <[email protected]>, Steven May <[email protected]> Subject: Re: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed Message-ID: <cb8b1d4c6616c649be06e4604857ee8605567...@hmhexchange.howardmemorial.com> Content-Type: text/plain; charset="us-ascii" Good afternoon everyone, We are having a difficult time getting the appropriate documentation to meet the bundle compliance even though everything is done correctly! Use of our Sepsis Screening and Evaluation Documentation tool is hit and missed although I can see by the labs and treatment protocol that they are doing it. On the IP side it is the issue with getting them to document to the Sepsis Shift Screen and Focus reassessment. With the physicians if they are here when patient is admitted to the floor they usually do an admit note that includes a focused reassessment so we will catch those. If it is after hours we are hoping to hold the ER physicians accountable to documenting a focused reassessment prior to moving patient to PCU or ICU. I would be open to suggestions for better documentation compliance also. Pam Pam From: Sepsisgroups [mailto:[email protected]] On Behalf Of Duane, Molly Sent: Thursday, April 05, 2018 11:18 AM To: [email protected] Subject: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed Hello All, I was wondering if your physicians were using the attestation statement instead of documenting the specific focused exam components. If so, how is that going? How did you implement this? We had a miss this month: even though the physician documented in his note the specific amount of fluid that was given, followed with "after these interventions the patient was reassessed", we missed because the attestation did not have a specific time included. The time the note was opened/started was used. This was an ED note, started at the beginning of the pt's visit, so that was prior to fluids being given. It is frustrating to see that the correct care is being given, yet we are missing on documentation technicalities. Does anyone have suggestions? Thanks, Molly Molly Duane RN, BSN, CCRN Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Mobile: 248-709-6218 DRH: 313-966-8087 HUH: 313-745-4340 Email: [email protected]<mailto:[email protected]> This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation. -------------- next part -------------- An HTML attachment was scrubbed... URL: <https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Fpipermail%2Fsepsisgroups-sepsisgroups.org%2Fattachments%2F20180405%2Ffa40c9f9%2Fattachment-0001.html&data=02%7C01%7Ctownsesr%40sutterhealth.org%7C8229f460e6ad415941ee08d5aafacb84%7Caef453eadaa243e0be62818066e9ff63%7C0%7C1%7C636602916540951633&sdata=d8aNFly081SvVVFuz5h5JYChAxTBQA%2BfN80HG0QmeCA%3D&reserved=0> ------------------------------ Message: 2 Date: Thu, 5 Apr 2018 20:35:43 +0000 From: Pender.Linda <[email protected]> To: "[email protected]" <[email protected]> Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 284, Issue 3 Message-ID: <sn6pr11mb2765422ef07f4d6a862b7feff6...@sn6pr11mb2765.namprd11.prod.outlook.com> Content-Type: text/plain; charset="iso-8859-1" Molly, We had the same issue with physicians documenting everything that occurred for hours within the note they started at the time of admission. We requested for the physicians to add a date and time of their re-assessments. This has surprisingly worked for us since we were able to show failures due to the technicalities. Linda G. Pender RRT-NPS Sepsis Coordinator Patient Care Services Administration Navicent Health phone: 478-633-6806 pager: 4444 KNOW Sepsis: Inside & Out Confidential Quality Improvement: Not for Disclosure Email: [email protected] -----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Thursday, April 05, 2018 4:07 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 284, Issue 3 [ W A R N I N G ] This email originated outside of Navicent Health. Do not click on links or attachments unless you recognize the sender and know the content is safe. Sender: [email protected] ========================================================================================================= * ** Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Flists.sepsisgroups.org%2Flistinfo.cgi%2Fsepsisgroups-sepsisgroups.org&data=02%7C01%7Ctownsesr%40sutterhealth.org%7C8229f460e6ad415941ee08d5aafacb84%7Caef453eadaa243e0be62818066e9ff63%7C0%7C1%7C636602916540951633&sdata=MKjjBwO53HB1jl%2BdQ77ti8DmfOCqS5%2BhI7kUiabZ9xk%3D&reserved=0 or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Question re: documentation of attestation that focused exam was completed (Duane, Molly) ---------------------------------------------------------------------- Message: 1 Date: Thu, 5 Apr 2018 12:17:56 -0400 From: "Duane, Molly" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Question re: documentation of attestation that focused exam was completed Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" Hello All, I was wondering if your physicians were using the attestation statement instead of documenting the specific focused exam components. If so, how is that going? How did you implement this? We had a miss this month: even though the physician documented in his note the specific amount of fluid that was given, followed with "after these interventions the patient was reassessed", we missed because the attestation did not have a specific time included. The time the note was opened/started was used. This was an ED note, started at the beginning of the pt's visit, so that was prior to fluids being given. It is frustrating to see that the correct care is being given, yet we are missing on documentation technicalities. Does anyone have suggestions? Thanks, Molly Molly Duane RN, BSN, CCRN Sepsis Program Coordinator Detroit Receiving Hospital Harper-Hutzel Hospital Mobile: 248-709-6218 DRH: 313-966-8087 HUH: 313-745-4340 Email: [email protected]<mailto:[email protected]> This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation. -------------- next part -------------- An HTML attachment was scrubbed... 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Any unauthorized review, retransmission, use, disclosure, dissemination, or other use of, or taking any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you are not the intended recipient, you are hereby notified that any reading, dissemination, distribution, copying, or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender immediately by reply e-mail, or by calling (478) 633-7272, and destroy the original message, attachments, and all copies thereof on all computers and in any other form. Thank you. Navicent Health. https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.navicenthealth.org%2F&data=02%7C01%7Ctownsesr%40sutterhealth.org%7C8229f460e6ad415941ee08d5aafacb84%7Caef453eadaa243e0be62818066e9ff63%7C0%7C1%7C636602916540951633&sdata=M%2BfxvvLQrdw9QbI6BI8ciOcM9TWvJDNf6Kyc88LMJTM%3D&reserved=0 ------------------------------ Message: 3 Date: Sat, 07 Apr 2018 01:25:43 +0300 From: [email protected] To: Sepsis List Serve <[email protected]> Subject: [Sepsis Groups] OB patients Message-ID: <[email protected]> Content-Type: text/plain; charset="utf-8" Hello All, We are initiating protocols to screen and treat obstetrical patients for Sepsis. Are your hospitals using the same protocols as for medical and surgical patients? ?If not, would you be willing to send me examples of protocols specific to obstetrics? Thank you, Rick Rutherford, MD Ventura County Medical Center Sent from myMail for iOS -------------- next part -------------- An HTML attachment was scrubbed... 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