Hello, team! As we recognize Sepsis Awareness Month throughout September, I have a few thoughts to share with the team. First, thank you for the care that you provide to every patient, every day. You are on the front lines fulfilling APP’s mission to provide safe, efficient, and compassionate patient care, and your time, expertise, and sacrifice do not go unnoticed. Just as everything else that has changed in our current practice environment due to the COVID pandemic, sepsis was and is not immune. During the pandemic, CMS gave hospitals an exemption for reporting the SEP 1 data. Because of this option, there has been much variability in reporting, as some facilities decided to suspend reporting while others chose to continue. As you would expect, this impacts our overall ability to track data and benchmark over time. While some of our sites did experience struggles with sepsis core measure compliance, our facilities with strong processes in place were able to remain successful with their sepsis initiatives, even through the most trying of times.
In the face of the SARS COV 1 viral infection, we have seen sepsis and respiratory failure take many lives and leave others with long-term healthcare implications. Our team led the way in not only identifying these at-risk viral sepsis cases and providing the needed supportive and cutting-edge care, but our leadership team sometimes met as frequently as twice a week to provide us with most current CDC recommended guidelines and expert support both operationally and clinically.
Though the past year, sepsis did not take a break, as evidenced by some of our facilities seeing an increase in overall sepsis mortality, even in those who have hardwired their processes and maintained compliance with appropriate protocols. The reason for this remains unclear, and further investigation is needed. The focus of the CMS core measure has been with the identification of the sepsis spectrum related to a 'bacterial' infection. The reality is that any infection can result in sepsis, regardless of viral, fungal, or parasitic pathology. This is the case with COVID infections. Patients who were infected early in the pandemic met every SIRS/Sepsis criteria without the ability to have a "magic bullet" to treat the underlying infection. Our team rose to the occasion, and through heavy personal sacrifice and personal exposure to the infection, continued to care for every one of our patients. I am so proud of our physicians’ and APCs’ efforts!
As we are now seeing the ebb and flow of the different variants in this continuing pandemic, sepsis continues to knock on our door, requiring us to strive for early identification, rapid treatment, and definitive solutions to streamline care to decrease mortality. We have made sepsis advances at many of our facilities: EMR implementation with sepsis alerts embedded in the program, automatic serial lactate repeats within our labs, and sepsis educational tools to support the treating providers, to name a few. As I am writing this article, I am reminded of the September 11 tragedy now recognizing its 20th anniversary. I am astounded by the resilience of our country and its people. No matter what adversity we face, we engage, evaluate, and determine how to best respond—and we survive. This also holds true for the pandemic, as well as our battle with sepsis! My advice to you is to continue the great work you do every day, look for the goodness in others, enjoy life, and provide love to those who need it most.
Brad Blaker, DO