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:
“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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7 measures recommended for removal or conditional removal, 25 for retention or conditional retention
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