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The SEP-1 Measure: What Is It, and How Does It Impact Sepsis Patients & Their Families?

June 22, 2021

SEP-1 provides guidelines for hospital clinicians treating patients with sepsis. This month, the National Quality Forum—the organization that endorses processes like SEP-1—is deciding whether to keep or remove the SEP-1 mandated measure. Read about why Sepsis Alliance is fighting to keep the SEP-1 measure in place.

 

“SEP-1” is shorthand for “The Severe Sepsis and Septic Shock Management Bundle.” It lays out guidelines for frontline hospital clinicians fighting sepsis. SEP-1  focuses on timely sepsis recognition and early intervention with lifesaving therapies. This emphasis on timing is critically important, as saving lives and limbs from sepsis is all about time: each hour of delay before a septic patient is treated is associated with a 4-9% increased risk of mortality.

Early Screening Is Vital

Because SEP-1 emphasizes early screening, it helps prevent sepsis progression to septic shock. This ultimately saves lives. On top of this lifesaving emphasis on catching sepsis early, the SEP-1 measure requires hospitals to gather and report data on how well they’re keeping up with the protocols —they must measure their SEP-1 compliance. Studies show that measuring hospital performance is related to better patient outcomes. In other words, the more a hospital must report on its care, the better care it gives. This measurement and reporting mandate is part of what makes SEP-1 so effective.

Widespread approval of the SEP-1 measure led to its incorporation into the Centers for Medicare and Medicaid Services in 2015. Any hospital that receives funding from Medicare or Medicaid must measure and report their SEP-1 compliance. This has had a huge impact on improving sepsis care inequity. By providing a standard protocol and reporting process for every sepsis patient, SEP-1 helps level the playing field in diagnosing and treating sepsis across race, socioeconomic status, geography, and insurance type. Under-resourced community hospitals can offer sepsis care comparable to well-funded academic facilities because of SEP-1. And it is the measure, which encourages compliance with the SEP-1 protocols, that makes it all happen.

Calls to Remove SEP-1

Despite these benefits, some groups are calling for the removal of the SEP-1 measure. They argue that the quick administration of antibiotics called for under SEP-1 protocols contributes to the growing problem of antimicrobial resistance (AMR). In their view, SEP-1 protocols do not allow enough time to determine which antibiotics (if any) a person needs, and this might contribute to antibiotic overuse and germ resistance. Sepsis Alliance understands and wholeheartedly agrees with concerns about antimicrobial resistance. In fact, AMR is a growing threat to sepsis prevention and treatment. The fewer drugs that work against infectious germs, the less clinicians will be able to treat infection and sepsis—so Sepsis Alliance has made ending superbugs a top advocacy priority.

Sepsis Alliance embraces these two responsibilities together: treating sepsis patients in a timely way and combating antimicrobial resistance. The organization does not see these as conflicting goals. No set of rules is perfect and, as new data become available, SEP-1 can be modified. In fact, those who developed SEP-1 have already proposed modifications to their guidelines to address some of these AMR-related concerns. But importantly, removing the mandated SEP-1 measure now would leave nothing similar in its place— nothing to ensure that the lifesaving, equitable benefits of the SEP-1 guidelines will continue to be implemented. We can always edit the guidelines we have and improve them—but, as sepsis patient advocates, loved ones, survivors, and the clinicians who care for them, we cannot afford to abandon them, or see their enforcement and compliance slip. This would surely occur if the SEP-1 measure is removed. There are lives and limbs at stake.

Help Retain SEP-1

In all, Sepsis Alliance believes that retaining the SEP-1 measure would assure that hospital leadership and clinicians maintain their focus on the number one cause of death in U.S. hospitals: sepsis. With modifications, the SEP-1 measure can support the continued screening, early recognition, and management of sepsis in hospitals— and improve care and save lives in every community.

 

You can make your voice heard. Sign your support for the continued measure of SEP-1 in hospitals here!