Sepsis Costs Go Beyond Dollars

Sepsis is not an infection; it is an expensive medical emergency that “is a life-threatening organ dysfunction caused by a dysregulated host response to infection.”¹

One of the costliest in-patient hospital conditions, sepsis has a national annual hospital expenditure of $23.6 billion.² Every hour of delay in getting tailored antibiotics to the patient—targeting the most likely pathogen—equates to a 7.6 percent increased likelihood of mortality.³

The effects of sepsis do not stop at discharge. Survivors often suffer from cognitive dysfunction and functional disabilities and may experience symptoms of depression, anxiety, and/or post-traumatic stress disorder (PTSD).^4,5 Wives of sepsis survivors are four times more likely to experience symptoms of depression. Twenty-five percent of relatives of survivors had anxiety, and 50 percent had PTSD six months after ICU discharge.^6,7,8

Anyone can become infected, but risk factors for sepsis include the very old, the very young, immunocompromised people, hospitalized patients, and those with liver or kidney disease.⁹ See The Flash section below for education resources.

Sepsis Readmissions and Mortality

Data show that, since the baseline period of 2019, there has been improvement in sepsis readmission rates and worsening of sepsis mortality rates (lower rates are better). 

Visit the HSAG HQIC Quality Improvement Innovation Portal (QIIP) to view your sepsis data by selecting the Measure category of Readmit-Mortality and Measures of Readmissions—Readmissions: Sepsis and Mortality: Sepsis.

Source: Medicare Fee-for-Service claims data. For additional details on measure specifications, please reference the HSAG HQIC Compendium of Measures. The baseline time period is 01/01/2019–12/31/2019 and current time period is 04/01/2022–03/31/2023 for readmissions and 05/01/2022–04/30/2023 for mortality.

HSAG HQIC Sepsis Tools

HSAG HQIC developed a screening tool, pathophysiology presentation, mortality toolkit, post-op checklist, hand hygiene posters, a sepsis zone tool for patients, and roadmaps to success for acute and critical access hospitals.

Teach-Back to Reduce Readmissions

A national trend is showing an increase in hospital readmissions. This may be because there is a post-COVID-19 decrease in overall mortality, an increase in discharges and patients seeking treatment, fewer community resources available, and barriers to follow-up appointments. Social determinants of health also play a big role in readmissions. To help reduce readmissions, ensure your providers and staff are using teach-back every time patients are educated.

Why teach-back? Learn more about health literacy with this 4.5-minute video from the American Medical Association (AMA).

HSAG HQIC teach-back resources.

HSAG Care Coordination Quickinar Series Session 20, Care Coordination and Teach-Back, event recording and slides.

Care Coordination

Quickinar Series

Continue your care coordination journey for managing avoidable hospital readmissions by registering for these short, 30-minute webinars (quickinars)—offered monthly, through May 2024. Find details and recordings for past presentations on the webpage.

1st Tuesdays. Next: October 3, 2023 | 2–2:30 p.m. ET (11 a.m. PT)

Emergency Preparedness Plan (EPP) Webinars

These short, 45-minute webinars discuss key areas for a successful EPP, followed by a Q&A session. Presentations cover up-to-date information/resources and areas of focus included in a comprehensive EPP.

Hosted by HSAG, in partnership with the California Association of Health Facilities (CAHF), Arizona Coalition for Healthcare Emergency Response (AzCHER), California Hospital Association (CHA), California Long-Term Care Ombudsman, the California Department of Public Health (CDPH), local health departments, the California Association of Long Term Care Medicine (CALTCM), and others.

3rd Wednesdays. Next: September 20, 2023 | 6–6:45 p.m. ET (3 p.m. PT)

Find on-demand quickinar recordings, slides, and podcasts for past HSAG HQIC learning series.

Health Equity Quickinar Series

This series addresses the many facets and criteria for hospitals to meet the new Centers for Medicare & Medicaid Services (CMS) Hospital Commitment to Health Equity Structural Measure and Social Drivers Screening Measures.

Patient/Family Engagement (PFE) Quickinar Series

This series addresses the CMS 5 Metrics for PFE and provides facilities a framework to engage patients and families in their care.

Quality and Safety Quickinar Series

Find resources to assist your quality improvement journey, from planning and preparation to sustaining your organization's gains.

Undercover Boss: Why This C-Suite Leader Silently Became an Emergency Medical Technician

Read how one C-suite leader spends time as part of the frontline staff, bridging the gap between the two.

"If every C-suite leader was required to spend time in a frontline worker's shoes, it would be a game-changer."

References

1. Singer M, et al. The Third International Consensus Definition for Sepsis and Septic Shock. JAMA. 2016; 801-810. https://jamanetwork.com/journals/jama/fullarticle/2492881

2. Torio CM, et al. (National Inpatient Hospital Costs. HCUP Statistical Brief. 2013; #204. https://europepmc.org/abstract/med/27359025

3. Kumar A, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critcal determinant of survival in human septic shock. Crit Care Med. 2006; 1589-96. https://journals.lww.com/ccmjournal/Abstract/2006/06000/Duration_of_hypotension_before_initiation_of.1.aspx

4. Iwashyna TJ. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010; 1787-94. https://www.ncbi.nlm.nih.gov/pubmed/20978258

5. Iwashyna TJ. Population burden of long-term survivorship after severe sepsis in older Americans. J Am Ger Soc. 2012; 1070-7. https://www.ncbi.nlm.nih.gov/pubmed/22642542

6. Rosendahl J. Physical and mental health in patients and spouses after intensive care of severe sepsis. Crit Care Med. 2013; 41. https://cdn.journals.lww.com/ccmjournal/Abstract/2013/01000/Physical_and_Mental_Health_in_Patients_and_Spouses.9.aspx

7. Davydow DS. A longitudinal investigation of posttraumatic stress and depressive symptoms over the course of the year following medical-surgical intensive care unit admission. Crit Care Med. 2012; 2335-41. https://www.sciencedirect.com/science/article/pii/S0163834312003933

8. Jones C. Post-traumatic stress disorder-related symptoms in relatives of patients following intensive care. Intens Care Med. 2004; 456-60. https://link.springer.com/article/10.1007/s00134-003-2149-5

This material was prepared by Health Services Advisory Group (HSAG), a Hospital Quality Improvement Contractor (HQIC) under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication No XS-HQIC-XT-09052023-01