Burden and Impact of Sepsis During the COVID-19 Pandemic | “Sepsis 2.5”: Bridging the Gaps Between Definitions and Outcomes on Patient Care and Denials
Session Descriptions:
This activity includes two sessions from Sepsis Alliance Summit to meet the minimum time requirement for nursing CE credits.
Burden and Impact of Sepsis During the COVID-19 Pandemic
COVID-19 has profoundly affected the global sepsis landscape. Since the beginning of the pandemic, millions of patients have been hospitalized with severe viral disease and organ dysfunction, and many have also developed serious bacterial and fungal infections. In this session, learners will examine the intersection of sepsis and COVID-19, including the rationale for and controversies surrounding the decision to label severe SARS-CoV-2 infections as “sepsis.” The presenters will also review current knowledge of the epidemiology and outcomes of sepsis in patients hospitalized with COVID-19.
“Sepsis 2.5”: Bridging the Gaps Between Definitions and Outcomes on Patient Care and Denials
The need to choose between Sepsis-2 and Sepsis-3 criteria presents great challenges for healthcare professionals and organizations. Sepsis-2 emphasizes early identification, but results in a high denial volume for reimbursement. Most insurance companies have adopted Sepsis-3 for reimbursement, but healthcare professionals who choose Sepsis-3 run the risk of delaying patient care and performing poorly on CMS’s SEP-1 Core Measure. In this session, presenters will discuss the concept of “Sepsis-2.5,” including what it is, why it was developed, and the approach to adoption and rollout taken within the John Peter Smith (JPS) Health Network system. The presenters will also review how, with “Sepsis-2.5,” JPS Health Network maintained SEP-1 bundle compliance greater than the national average and a mortality rate lower than the global average, while simultaneously mitigating denial risk and maintaining accurate reimbursement.
These sessions were originally recorded in September 2022 as part of Sepsis Alliance Summit.
Target Audience
Nurses, advanced practice providers, physicians, emergency responders, pharmacists, medical technologists, respiratory therapists, physical/occupational therapists, infection prevention specialists, data/quality specialists, and more.
Learning Objectives
At the end of the session, the learner should be able to:
Burden and Impact of Sepsis During the COVID-19 Pandemic
- Describe current understanding of the pathophysiology of SARS-CoV-2-related organ dysfunction;
- Discuss potential benefits and controversies around labeling severe COVID-19 as “sepsis”;
- Review current knowledge of the prevalence, characteristics, risk factors, outcomes, and implications for clinical care associated with SARS-CoV-2-related sepsis and non-SARS-CoV-2-related sepsis in patients hospitalized with COVID-19.
“Sepsis 2.5”: Bridging the Gaps Between Definitions and Outcomes on Patient Care and Denials
- Understand the difference between Sepsis-2 and Sepsis-3 definitions and the need for a Sepsis-2.5;
- Analyze key data metrics on sepsis performance at their organization to determine if Sepsis-2.5 is appropriate;
- Apply strategies for implementing Sepsis-2.5.
Chanu Rhee, MD, MPH, FIDSA
Associate Hospital Epidemiologist, Brigham and Women’s Hospital
Chanu Rhee, MD, MPH, FIDSA, is an infectious disease/critical care physician and Associate Hospital Epidemiologist at Brigham and Women’s Hospital and Associate Professor of Population Medicine and Medicine at Harvard Medical School. He is a nationally recognized expert in epidemiology, surveillance, diagnosis, prevention, and treatment of sepsis and infections in critically ill patients. Within the Mass General Brigham healthcare system, he has been an institutional leader in improving sepsis care, preventing healthcare-associated infections, and developing and implementing the infection control response to COVID-19. As a Centers for Disease Control and Agency for Healthcare Research and Quality-funded investigator, he has led numerous studies that have advanced our understanding of sepsis epidemiology and improved the nation’s capacity to monitor its incidence and outcomes. Dr. Rhee is an associate editor for Clinical Infectious Diseases and a member of the editorial board for Critical Care Medicine and Critical Care Explorations. He has been involved in several regional and national committees focusing on sepsis, including the Massachusetts Sepsis Consortium, the American College of Emergency Physicians Sepsis Guidelines Panel, and the Infectious Diseases Society of America Sepsis Task Force.
Claire N. Shappell, MD
Research Fellow, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital
Claire Shappell, MD, is a research fellow in the Division of Pulmonary and Critical Care Medicine at Brigham and Women’s Hospital and the Department of Population Medicine at Harvard Medical School/ Harvard Pilgrim Health Care Institute. She graduated from medical school and completed residency in Internal Medicine at the University of Chicago Pritzker School of Medicine/ University of Chicago Medical Center and recently completed her clinical Pulmonary and Critical Care fellowship at Brigham and Women’s Hospital.
Dr. Shappell’s research focuses on using electronic health record data to improve surveillance, diagnosis, prevention, and care for patients with sepsis and COVID-19. Current projects include investigations of sepsis prevalence and outcomes in patients hospitalized with COVID-19, effects of variable definitions of COVID-19 hospitalization on public health metrics and observational research, and predictors of sepsis bundle non-compliance. She is supported by a post-doctoral NIH F32 award and is earning her Masters in Public Health at the Harvard T.H. Chan School of Public Health. Clinically, Dr. Shappell works as an associate physician in the Medical Intensive Care Unit at Brigham and Women’s Hospital.
Alexis Wells, RN, MSN, LSSYB, CCDS
Quality Educator, Outcomes Management, JPS Health Network
Alexis Wells, RN, MSN, LSSYB, CCDS, has been a registered nurse since 2008. She has worked in various areas, including CVICU, neuro ICU, med/surg ICU, telemetry, bone marrow transplant unit, and home hospice, which provided her with a well-rounded foundation when she became a clinical documentation specialist (CDS) in 2015. Within six months, Ms. Wells was promoted to the clinical coordinator role, in which she facilitated healthcare professional education and cultivated relationships with essential ancillary departments such as dietary, wound care, and IT. In 2018, Ms. Wells was hired at John Peter Smith (JPS) hospital as the CDI Quality Assurance Auditor, where she continued working towards the same goals of breaking down barriers and improving workflow and engagement of everyone involved with clinical documentation. In December 2021, Ms. Wells transitioned to a new role at John Peter Smith, becoming the Quality Educator for the entire organization.
Ms. Wells has taken care of multiple patients with sepsis and understands that early identification and intervention are key to survival. This led her to act when the question was posed: how do you bridge patient care and reimbursement when it comes to the septic population?
Stacia Gandee, RHIA, CCS, CDIP, LSSYB
Manager of Clinical Documentation Integrity, Health Information Management, JPS Health Network
Stacia Gandee, RHIA, CCS, CDIP, LSSYB, began serving as a clinical documentation specialist (CDS) in February 2017 at John Peter Smith (JPS) hospital. She was quickly promoted to the specialized role of Clinical Validation CDS in 2019, and then again to the manager role in 2020. Prior to this, Ms. Gandee worked as a coder at Baylor Scott & White as well as a contract coder for HIMagine.
Ms. Gandee is a member of her organization’s sepsis committee and has attended national conferences to ensure her CDI Program is optimizing its impact on patient care, documentation, and coding of sepsis. Ms. Gandee brings ambition, knowledge, and coding expertise that is instrumental to organization-wide change in practice as it relates to the integrity of clinical documentation and coding.
Provider approved by the California Board of Registered Nursing, Provider Number CEP17068 for 1.4 contact hours.
Other healthcare providers will receive a certificate of attendance for 1.0 contact hours.
Medical Disclaimer
The information on or available through this site is intended for educational purposes only. Sepsis Alliance does not represent or guarantee that information on or available through this site is applicable to any specific patient’s care or treatment. The educational content on or available through this site does not constitute medical advice from a physician and is not to be used as a substitute for treatment or advice from a practicing physician or other healthcare provider. Sepsis Alliance recommends users consult their physician or healthcare provider regarding any questions about whether the information on or available through this site might apply to their individual treatment or care.
Available Credit
- 1.00 Participation
- 1.40 RN CE Contact HoursProvider approved by the California Board of Registered Nursing, Provider Number CEP17068.