Federal sepsis guidelines largely ineffective, UPMC study finds

By Mackenzie Bean for Becker’s Hospital Review

The care bundle CMS implemented in 2015 to improve outcomes for sepsis patients did not lead to significant improvements at Pittsburgh-based UPMC, according to a Annals of Internal Medicine.

Researchers at the University of Pittsburgh School of Medicine analyzed EHR data from 54,224 visits of adult patients at 11 UPMC hospitals. They compared sepsis outcomes from the two years before and two years after the health system adopted the sepsis bundle.

Overall, researchers found the bundle wasn’t associated with clinically meaningful patient outcomes. The biggest change researchers saw was that clinicians ramped up ordering for lactate measurement, but this testing did not translate to fewer deaths or other changes in care delivery.

“Tests like lactate are useful when they give you information that you can act on to improve patient outcomes,” senior author Jeremy Kahn, MD, professor of critical care medicine and health policy and management at Pitt, said in a news release. “But testing for the sake of reporting that you did the test is not helpful unless you also do other things.”

The findings make a case for refining the current sepsis bundle to reap more improvements in sepsis care, the study authors said. However, they also noted their findings are limited to UPMC, which has long been working to improve sepsis outcomes.

“It is possible UPMC already had achieved the improvements that SEP-1 might induce at other hospitals,” said lead author Ian Barbash, MD, a UPMC intensivist and assistant professor of medicine at Pitt.