IDSA Provides Comments to the National Quality Forum Patient Safety Standing Committee on the Severe Sepsis and Septic Shock: Early Management Bundle

With sign-on support from the American College of Emergency Physicians, American Hospital Association, Pediatric Infectious Diseases Society, Society for Healthcare Epidemiology of America, Society of Hospital Medicine and Society of Infectious Diseases Pharmacists, IDSA has stated its opposition to the National Quality Forum’s re-endorsement of the Severe Sepsis and Septic Shock: Early Management Bundle (SEP-1) quality measure, as the Society has major concerns with the SEP-1 measure as it is currently specified.

The SEP-1 quality measure has helped raise awareness of sepsis and improved the standard of care for this deadly condition. However, data have emerged over the past 6 years that have identified problems that, if rectified, would significantly strengthen SEP-1 and reduce unintended consequences caused by the current measure.

The major revisions IDSA and the collaborating societies have requested are:

1. Focus the bundle on the subset of patients most likely to benefit from rapid and aggressive interventions, i.e., those with septic shock, not those without shock;
2. Minimize antibiotic overuse and adverse effects by eliminating patients with sepsis without shock from the bundle and redefining the goals for time to antibiotic delivery;
3. Eliminate bundle elements that do not contribute to improved patient outcomes, such as measuring serial lactates;
4. Streamline the reporting process to focus on clinical outcomes;
5. Make reporting electronic with data that are easily extractable from the electronic health record;
6. Get input and support for intended changes from all professional organizations most affected by the SEP-1 measure.