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Hospitals Linking Sepsis Cases and Readmissions, Identifying Best Practices and Prevention Efforts

June 29, 2017

Sepsis is the body’s life-threatening, toxic response to infection that can lead to tissue damage, organ failure, and death.There are more than 1.6 million cases of sepsis every year in the United States. Approximately 25 percent of these patients die.

Hospitals in Pennsylvania and across the country have been working to adopt best practices to more effectively identify and treat sepsis. Under The Hospital and Healthsystem Association of Pennsylvania’s (HAP) Hospital Improvement Innovation Network (HIIN), health care experts are teaming up with hospitals to address this critical issue. Their collective goals are to reduce sepsis mortality following severe sepsis and/or septic shock by 20 percent, and to reduce 30-day readmissions from any cause, including sepsis, by 12 percent.

The good news is that mortality after sepsis is decreasing due to the adoption of best practices in identifying and treating sepsis. Unfortunately, survivors often face long-term effects post-sepsis, including amputations, anxiety, memory loss, chronic pain and fatigue, and more.

Many sepsis survivors require readmission to the hospital. In a Healthcare Cost and Utilization Project (HCUP) among patients readmitted after a stay with septicemia as the principle diagnosis, 51.5 percent were readmitted within 30 days in 2005, compared to 62.3 percent readmitted within 30 days in 2010––a 21 percent increase. Among children, almost half who have had severe sepsis end up being hospitalized again. HCUP is a group of powerful health care databases, software tools, and products for advancing research.

In response to this data, many hospitals are focusing on the links between sepsis and hospital readmissions. A study published during January 2017, in the Journal of the American Medical Association from the VA Pittsburgh Healthcare System in Pennsylvania, states that sepsis is the leading cause of 30-day readmissions in the United States.

HAP’s readmission and sepsis project managers participate in the Partnership for Patients Sepsis and Readmission Affinity Group. This national group has formed to share knowledge about causes for readmissions following sepsis, and to develop a way to identify patients at highest risk of readmission to a hospital and how to prevent that from happening.

For example, some states have noted that a high number of patients are readmitted from post-acute care facilities, which underscores the need for hospitals to collaborate with these facilities after a sepsis patient is discharged to those settings.

HAP’s HIIN readmission and sepsis project managers are collaborating to prepare a resource guide of the most up-to-date literature and tools for hospitals to reference when they are drilling down to address the causes of readmissions in their hospitals.

The Pennsylvania Health Care Cost Containment Council recently released a report: Pennsylvania’s “Super-Utilizers” of Hospital Care. Super-utilizers are defined as patients with five or more hospital admissions per year. Sepsis was the number one reason for these super-utilizer inpatient care admissions in 43 percent of Pennsylvania counties during 2016. Fifty-nine of 67 counties list sepsis as one of the three top reasons for admissions.

For information about HAP’s HIIN readmission and sepsis collaborative, please contact Sandra L. Abnett, readmissions project manager, at sabnett@haponline.org, or Margaret M. Miller, sepsis project manager, at mmiller@haponline.org.

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