Patients who received ALL of the following:

Within three hours of presentation of severe sepsis:

• Initial lactate level measurement

• Broad spectrum or other antibiotics administered

• Blood cultures drawn prior to antibiotics

AND received within six hours of presentation of severe sepsis. ONLY if the initial lactate is elevated:

• Repeat lactate level measurement

AND within three hours of initial hypotension:

• Resuscitation with 30 mL/kg crystalloid fluids

OR within three hours of septic shock:

• Resuscitation with 30 mL/kg crystalloid fluids

AND within six hours of septic shock presentation, ONLY if hypotension persists after fluid administration:

• Vasopressors are administered

AND within six hours of septic shock presentation, if hypotension persists after fluid administration or initial lactate >= 4 mmol/L:

• Repeat volume status and tissue perfusion assessment is performed

Inpatients age 18 and over with an ICD-10-CM Principal or Other Diagnosis Code of Sepsis, Severe Sepsis, or Septic Shock and not equal to U07.1 (COVID-19).

The following patients are excluded from the denominator:

• Patients with an ICD-10-CM Principal or Other Diagnosis Code of U07.1 (COVID-19)

• Directive for Comfort Care or Palliative Care within six hours of presentation of severe sepsis

• Directive for Comfort Care or Palliative Care within six hours of presentation of septic shock

• Administrative contraindication to care within six hours of presentation of severe sepsis

• Administrative contraindication to care within six hours of presentation of septic shock

• Length of Stay >120 days

• Transfer in from another acute care facility

• Patients enrolled in a clinical trial for sepsis, severe sepsis or septic shock treatment or intervention

• Patients with severe sepsis who are discharged within six hours of presentation

• Patients with septic shock who are discharged within six hours of presentation

• Patients receiving IV antibiotics for more than 24 hours prior to presentation of severe sepsis

None

None

Electronic Health Data, Paper Patient Medical Records

National Quality Forum 2022 Key Rural Measures: An Update List of Measures to Advance Rural Health Priorities, Draft 1, page 1-26

Download from: www.qualityforum.org/Publications/2022/08/2022KeyRural_Measures__An_Updated_List_of_Measures_to_Advance_Rural_Health_Priorities.aspx

Technical Specification: p4qm.org/measures/0500