ArticleAnnals of internal medicine2021
Treatment Patterns and Clinical Outcomes After the Introduction of the Medicare Sepsis Performance Measure (SEP-1).
Article in Annals of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review.Annals of internal medicine · 2025Pooled it
- Sepsis Diagnostic Excellence: Development and Validation of a Theoretical Framework for Conceptualizing Accurate, Timely Sepsis Diagnosis.Critical care explorations · 2026Observational
- Development and validation of an algorithm to identify severe sepsis onset from electronic medical records.JAMIA open · 2026Article
- A decade of SEP-1 compliance and sepsis mortality in the United States.Critical care (London, England) · 2026Article
- Clinical Outcomes for Emergency Department Presentations of Sepsis Managed on a Clinical Pathway: A Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2026Review
- Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009-2018.Open forum infectious diseases · 2026Article
- Diagnostic safety and quality optimization in sepsis study protocol.Journal of hospital medicine · 2025Article
- Evaluating sepsis watch generalizability through multisite external validation of a sepsis machine learning model.NPJ digital medicine · 2025Article
- Decision analysis model of rapid versus deferred antibiotic initiation in patients with suspected sepsis in the emergency department.Intensive care medicine · 2025Article
- What Can We Learn from Differences in Hospitals' Sepsis Care?American journal of respiratory and critical care medicine · 2025Article
- Complex Sepsis Presentations, SEP-1 Compliance, and Outcomes.JAMA network open · 2025Article
- Variation in Corticosteroid Prescribing Practices for Patients With Septic Shock.Critical care explorations · 2025Article
- Factors and outcomes associated with under- and overdiagnosis of sepsis in the first hour of emergency department care.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Observational
- Challenges with reinforcement learning model transportability for sepsis treatment in emergency care.NPJ digital medicine · 2025Article
- Article
- Trends in Empiric Broad-Spectrum Antibiotic Use for Suspected Community-Onset Sepsis in US Hospitals.JAMA network open · 2024Article
- Improving Sepsis Outcomes in the Era of Pay-for-Performance and Electronic Quality Measures: A Joint IDSA/ACEP/PIDS/SHEA/SHM/SIDP Position Paper.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Focused Cardiac Ultrasound Findings of Fluid Tolerance and Fluid Resuscitation in Septic Shock.Critical care explorations · 2023Article
- Institutional Structures and Processes to Support Sepsis Care: A Multihospital Study.Critical care explorations · 2023Article
- Evaluation of the Recommended 30 cc/kg Fluid Dose for Patients With Septic Shock and Hypoperfusion With Lactate Greater Than 4 mmol/L.Critical care explorations · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMedicare requires that hospitals report on their adherence to the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1).
objectiveTo evaluate the effect of SEP-1 on treatment patterns and patient outcomes.
designLongitudinal study of hospitals using repeated cross-sectional cohorts of patients.
setting11 hospitals within an integrated health system. PATIENTS: 54 225 encounters between January 2013 and December 2017 for adults with sepsis who were hospitalized through the emergency department.
interventionOnset of the SEP-1 reporting requirement in October 2015. MEASUREMENTS: Changes in SEP-1-targeted processes, including antibiotic administration, lactate measurement, and fluid administration at 3 hours from sepsis onset; repeated lactate and vasopressor administration for hypotension within 6 hours of sepsis onset; and sepsis outcomes, including risk-adjusted intensive care unit (ICU) admission, in-hospital mortality, and home discharge among survivors.
resultsTwo years after its implementation, SEP-1 was associated with variable changes in process measures, with the greatest effect being an increase in lactate measurement within 3 hours of sepsis onset (absolute increase, 23.7 percentage points [95% CI, 20.7 to 26.7 percentage points]; LIMITATION: Data are from a single health system.
conclusionImplementation of the SEP-1 mandatory reporting program was associated with variable changes in process measures, without improvements in clinical outcomes. Revising the measure may optimize its future effect. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.