IMPROVING COMPLIANCE TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) SEPSIS BUNDLE USING EPIC EMR INFORMATICS

Abstract

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Sepsis is a common cause of mortality and morbidity affecting over 1.5 million individuals annually in the United States alone. Centers for Medicare and Medicaid Services requires hospitals to report compliance with a sepsis treatment bundle as part of its Inpatient Quality Reporting Program. The Specific aim of our study was to improve the CMS sepsis bundle compliance by 20% or more in a single tertiary care center using an Epic EMR based automated intervention for timely initiation and documentation of sepsis bundle METHODS: The study included all adult patients admitted with sepsis sampled according to CMS specifications from March 2018 to March 2019. The cohort was divided into pre and post-intervention groups and each studied for 6 months period. The CMS sepsis bundle compliance rate was tracked monthly using report generation through Epic MIDAS Analytics. We implemented multiple Epic based intervention including computerized decision support systems (CDSSs) to prompt an automated order set for the sepsis bundle ( antibiotics, blood cultures, 30 ml/kg fluid and lactate measurement) and admission note template modification to document tissue percussion assessment for all the inpatient admissions in an attempt to increase compliance with the most commonly missing bundle elements. RESULTS: We studied a total of 430 patient, with a baseline compliance rate of 43% with 99% control limits in the pre-intervention group. After implementation of the Epic based decision bundles and new admission note templates, the compliance rate increased to a mean of 89% with 99% control limits, with achievement of 100% compliance rate for 2 months out of the 6 in the post-intervention period. CONCLUSIONS: Our QI effort was associated with significant increase in sepsis bundle compliance, that was sustained during the 6 month study cohort due to a systemwide implementation through EMR. Informatics based implementation through electronic medical record system (EMR) like Epic can help improve compliance to sepsis quality metrics. CLINICAL IMPLICATIONS: By using a simple system wide EMR based intervention, a large scale improvement in sepsis quality of care can be achieved. DISCLOSURES: No relevant relationships by Anson Babu, source=Web Response No relevant relationships by NARESH BASSI, source=Web Response No relevant relationships by Michele Cave, source=Web Response No relevant relationships by Amitabh Chandra, source=Web Response No relevant relationships by janine Good, source=Web Response No relevant relationships by Thaddeus Pula, source=Web Response No relevant relationships by Muhammad Sameed, source=Web Response No relevant relationships by Amanda Wright, source=Web Response No relevant relationships by Jennie Zhang, source=Web Response