From the March 2016 issue of HealthCare Business News magazine
By: Jill Rathbun
Effective Oct. 1, 2015, for any hospital discharges where the patient was age 18 or older with a diagnosis of sepsis, severe sepsis or septic shock, a new quality measure regarding the management of that patient will have to be reported by hospitals to Medicare. One of the clinical elements of the care that may be performed so that the hospital can report this new quality measure is bedside cardiovascular ultrasound.
The Hospital Inpatient Quality Reporting (Hospital IQR) Program is administered by the Centers for Medicare & Medicaid Services (CMS) and it pays hospitals that successfully report designated quality measures a higher annual update to their payment rates. Hospitals that do not successfully report quality measures see their annual increase in Medicare payments reduced by 2 percentage points per year. Effective Oct. 1, 2015, hospitals will need to submit information on this new Severe Sepsis and Septic Shock Management Bundle Measure (NQF Measure # 0500) to ensure their payments are not reduced in FY 2018.
This data reported by hospitals about their success in completing the activities in this measure, including the option of using bedside cardiovascular ultrasound if hypotension persists and volume status and tissue perfusion assessment is needed, will be reported on the publically available Hospital Compare website starting October 2017. Individuals will then be able to see how well the hospitals in their area are performing on these activities.
“Integrating of bedside cardiovascular ultrasound into the protocols that are adopted by hospitals to enhance the quality of care provided to these very sick sepsis patients is very important. Adding the accountability factor of a quality measure in the hospital quality reporting programs will hopefully increase adoption of these clinical practices,“ said Diku Mandavia, M.D., FACEP FRCPC, chief medical officer and senior vice president, FUJIFILM SonoSite Inc.
This new management of sepsis, severe sepsis or septic shock measure joins other existing measures in the Hospital Inpatient Quality Reporting Program that may require the use of ultrasound to help in meeting the measure’s goals. Specifically, the hospital measures regarding central-line associated bloodstream infections and the PSI-90 — Patient Safety for Selected Indicators Composite, which includes the iatrogenic pneumothorax at the time of venous catheterization measure — should be considered by a hospital when integrating protocols for the use of ultrasound in providing high-quality patient care.
