The Sepsis Early Recognition and Response Initiative (SERRI)

Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Pinn, Theresa T.; Tran, Shirley K.; Nicolás, Juan Carlos Ortíz; Rose, Alexis L.; Shirkey, Beverly A.; Disbot, Maureen; Masud, Faisal; Wray, Nelda P.

doi:10.1016/s1553-7250(16)42015-5

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…SERRI and the precedent program on which its design was based have been reported elsewhere, 12 , 13 as have the characteristics of the participating acute care hospitals. 13 Briefly, the 6 hospitals, with capacity of 140–799 adult beds, are located within and outside the Houston metropolitan area, and are a mix of not-for-profit and for-profit facilities. The hospital stays reported here are sepsis-associated stays in persons aged 18 years and above that occurred during the 12-month period from February 2012 through January 2013.…”

Section: Methodsmentioning

confidence: 99%

Outcomes and Resource Use of Sepsis-associated Stays by Presence on Admission, Severity, and Hospital Type

et al. 2016

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Objective:To establish a baseline for the incidence of sepsis by severity and presence on admission in acute care hospital settings before implementation of a broad sepsis screening and response initiative.Methods:A retrospective cohort study using hospital discharge abstracts of 5672 patients, aged 18 years and above, with sepsis-associated stays between February 2012 and January 2013 at an academic medical center and 5 community hospitals in Texas.Results:Sepsis was present on admission in almost 85% of cases and acquired in-hospital in the remainder. The overall inpatient death rate was 17.2%, but was higher in hospital-acquired sepsis (38.6%, medical; 29.2%, surgical) and Stages 2 (17.6%) and 3 (36.4%) compared with Stage 1 (5.9%). Patients treated at the academic medical center had a higher death rate (22.5% vs. 15.1%, P<0.001) and were more costly ($68,050±184,541 vs. $19,498±31,506, P<0.001) versus community hospitals.Conclusions:Greater emphasis is needed on public awareness of sepsis and the detection of sepsis in the prehospitalization and early hospitalization period. Hospital characteristics and case mix should be accounted for in cross-hospital comparisons of sepsis outcomes and costs.

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Section: Methodsmentioning

confidence: 99%

Outcomes and Resource Use of Sepsis-associated Stays by Presence on Admission, Severity, and Hospital Type

et al. 2016

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“…Adequate treatment of early sepsis may have improved patient survival in our cohort. 7,[34][35][36] Thus, the relationship between clonality and mortality may prove differently under other sepsis protocols. Furthermore, the clonality cut point of 0.072 was specific for the risk of developing sepsis and not for predicting mortality.…”

Section: Discussionmentioning

confidence: 99%

Pre-transplant T-cell Clonality

Jones

Moore

et al. 2021

Annals of Surgery

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“…33 Additionally, health systems may have begun preparing for rules that required reporting of sepsis outcomes and processes for patients discharged on or after October 1, 2015. 34 Prior to DSRIP, CMS, the National Quality Forum, the Joint Commission, and AHRQ developed performance measures, incentive programs, public reporting initiatives, and other programs aimed at improving VTE prevention. 35 These various nationwide initiatives likely drove quality improvement initiatives in hospitals across California to improve compliance and avoid reductions in reimbursements.…”

Section: Discussionmentioning

confidence: 99%

Evaluating inpatient adverse outcomes under California's Delivery System Reform Incentive Payment Program

Keller

Chen²,

Godwin

et al. 2020

Health Services Research

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Objective The California Delivery System Reform Incentive Payment Program (DSRIP) provided incentive payments to Designated Public Hospitals (DPHs) to improve quality of care. We assessed the program's impact on reductions in sepsis mortality, central line–associated bloodstream infections (CLABSIs), venous thromboembolisms (VTEs), and hospital‐acquired pressure ulcers (HAPUs). Data Sources We used 2009‐2014 discharge data from California hospitals. Study Design We used a pre‐post study design with a comparison group. We constructed propensity scores and used them to assign inverse probability weights according to their similarity to DPH discharges. Interaction term coefficients of time trends and treatment group provided significance testing. Data Extraction We used Patient Safety Indicators for CLABSI, HAPU, and VTE, and constructed a sepsis mortality measure. Principal Findings Discharges from DPHs and non‐DPHs both saw decreases in the four outcomes over the DSRIP period (2010‐2014). The difference‐in‐difference estimator (DD) for sepsis was only significant during two time periods, comparing 2010 with 2012 (DD: −2.90 percent, 95% CI: −5.08, −0.72 percent) and 2010 with 2014 (DD: −5.74, 95% CI: −8.76 percent, −2.72 percent); the DD estimator was not significant comparing 2010 with 2012 (DD: −1.30, 95% CI: −3.18 percent, 0.58 percent) or comparing 2010 with 2013 (DD: −3.05 percent, 95% CI: −6.50 percent, 0.40 percent). For CLABSI, we did not find any meaningful differences between DPHs and non‐DPHs across the four time periods. For HAPU and VTE, the only significant DD estimator compared 2014 with 2010. Conclusions We did not find that DPHs participating in DSRIP outperformed non‐DPHs during the DSRIP program. Our results were robust to multiple sensitivity analyses. Given multiple concurrent inpatient safety initiatives, it was challenging to assign improvements over time periods to DSRIP.

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The Sepsis Early Recognition and Response Initiative (SERRI)

Cited by 14 publications

References 27 publications

Outcomes and Resource Use of Sepsis-associated Stays by Presence on Admission, Severity, and Hospital Type

Outcomes and Resource Use of Sepsis-associated Stays by Presence on Admission, Severity, and Hospital Type

Pre-transplant T-cell Clonality

Evaluating inpatient adverse outcomes under California's Delivery System Reform Incentive Payment Program

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