• NQF has endorsed changes to an element of a sepsis measure, the Severe Sepsis and Septic Shock: Management Bundle (NQF measure #0500), that makes the use of a central venous catheter to monitor blood oxygen or pressure levels optional instead of required.

    The endorsement follows an ad hoc review of the measure by NQF’s Patient Safety Standing Committee, in light of new scientific evidence that found that patients with severe sepsis who received this invasive monitoring (known as early goal-directed therapy) had no different outcomes than those who received care without it. After initially recommending the removal of the element of the measure pertaining to invasive monitoring, the committee reached a compromise solution between the measure developer, Henry Ford Hospital, and key stakeholders, including the Society of Critical Care Medicine and the American College of Emergency Physicians. The revised measure allows reassessment of a septic patient’s condition through other means.

    The review of the sepsis measure was part of the first phase of NQF’s Patient Safety Measures Project; the second phase is now underway. The project aims to address gaps in the measurement of patient safety and identify how providers can best approach minimizing the risk of patient safety events. In addition, the project focuses on aligning patient safety measures across settings of care.

    In addition to the sepsis measure, NQF endorsed eight other measures that were evaluated or reevaluated as part of this project, including:

    • 0138 National Healthcare Safety Network (NHSN) Catheter-Associated Urinary Tract Infection (CAUTI) Outcome Measure
    • 0139 National Healthcare Safety Network (NHSN) Central Line-Associated Bloodstream Infection (CLABSI) Outcome Measure
    • 0555 INR Monitoring for Individuals on Warfarin
    • 0556 INR for Individuals Taking Warfarin and Interacting Anti-Infective Medications
    • 0541 Proportion of Days Covered (PDC): 3 Rates by Therapeutic Category
    • 0684 Percent of Residents with a Urinary Tract Infection (Long-Stay)
    • 2337 Antipsychotic Use in Children Under 5 Years Old
    • 2371 Annual Monitoring for Patients on Persistent Medications

    “Although healthcare quality has greatly improved, unsafe care and medical errors still kill thousands of patients each year,” said NQF Patient Safety Standing Committee Co-Chair Ed Septimus, MD. “NQF’s work, through its Patient Safety Standing Committee, is an important step forward to protect patients from harm and lead us to better, more equitable, and more affordable care.” Septimus is the medical director of infection prevention and epidemiology at HCA.

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