Physicians' concerns over CMS sepsis bundle

In the five months since CMS released its sepsis management bundle, a major change to the definition of sepsis is causing some concerns amongst physicians. In February, an international task force ruled that systemic inflammatory response syndrome (SIRS) shouldn’t be used when diagnosing sepsis. SIRS can be caused by many different, sometimes benign, factors and the task force said that it isn’t a reliable sepsis indicator.

That said, the CMS bundle was released in October 2015, and still uses a SIRS diagnosis as the trigger to begin sepsis management. Paul Bozyk, MD,  assistant director of the medical ICU at Beaumont Hospital in Royal Oak, Michigan, said that for smaller hospitals, the resources to meet CMS’s proscribed response to a SIRS diagnosis may be a significant burden.

"Sepsis protocols can be tricky on a medical floor. If you can get fluids, antibiotics, and lactic acid measurements, then you've checked the boxes on the three-hour bundle. But they might not have the resources to handle the six-hour bundle, which requires more intensive care," he told HealthLeaders.
Bozyk also said the bundle leaves little to no room for clinical decision-making and that incorrectly treating a patient for sepsis can prove harmful. "We can't always assume that SIRS presentation is sepsis," he added.

Read the full story on the CMS sepsis bundle at HealthLeaders Media.