At the federal level, the Centers for Medicare and Medicaid Services (CMS) instituted a sepsis quality measure as part of its Hospital Inpatient Quality Reporting Program (IQRP) in October 2015 ( 9). In New York State, where hospitals are required to report their compliance with guideline-based sepsis treatment bundles, adherence to these bundles is associated with lower sepsis mortality ( 4). One approach to improve the early recognition and treatment of sepsis across the health system is to use regulatory mandates for sepsis care ( 8). Identifying and treating sepsis early in its course can reduce sepsis-related morbidity and mortality, but many patients with sepsis do not receive early and potentially life-saving therapy ( 4– 7). Beyond the human toll of morbidity and mortality, sepsis imposes substantial financial costs, accounting for over $20 billion in annual US hospital spending ( 3). Among hospitalized patients, sepsis is the leading cause of death ( 2). Sepsis is a common cause of morbidity and mortality, affecting over 1.5 million individuals annually in the United States alone ( 1). Better hospital performance on SEP-1 was associated with higher rates of timely head CT interpretation for stroke patients (rho=0.16, p<0.001), more frequent aspirin administration for patients with chest pain or heart attacks (rho=0.24, p<0.001), and shorter median time to EKG for patients with chest pain (rho=−0.12, p<0.001). Compared to hospitals with worse SEP-1 performance, hospitals with better SEP-1 performance tended to be smaller, for-profit, non-teaching, and with intermediate-sized ICUs. Among hospitals reporting SEP-1 performance data, overall bundle compliance was generally low, but it varied widely across hospitals (mean and standard deviation: 48.9% ± 19.4%). The most common reason for non-reporting was an inadequate case volume. SEP-1 reporting was more common in larger, nonprofit hospitals. A total of 3,283 hospitals were eligible for the analysis, of which 2,851 (86.8%) reported SEP-1 performance data. We examined the hospital factors associated with reporting SEP-1 data, the hospital factors associated with performance on the SEP-1 measure, and the relationship between SEP-1 performance and performance on other quality measures related to time-sensitive medical conditions.
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