Critical Care Network


Sepsis and Shock Section

SEP-1 measure saves lives, let’s not debate!

On December 21, 2021, the National Quality Form (NQF) re-endorsed Measure 0500 Severe Sepsis and Septic Shock: Management Bundle, which CMS adopts as the SEP-1 core measure. The decision was initially met by a request for appeal. On April 29, 2022, the appeals board met to adjudicate the appeal and voted unanimously to uphold the Standards Approval Committee (CSAC) decision to endorse the measure once again (

The appeals board voted 5-0 on whether procedural errors reasonably affected the outcome of the original endorsement and whether there was new information or evidence unavailable at the time of the CSAC endorsement decision that would reasonably affect the outcome of the original endorsement decision.

The implementation of NQF 0500 and SEP-1 continues to spark controversy in the medical community even though the results of this bundled approach support an opportunity to save lives. SEP-1 compliance is associated with a lower 30-day mortality, and rendering this care saves lives.

In the Townsend, et al cohort study (Chest. 2022 Feb;161[2]:392) examining patient level Medicare data from October 2015 – March 2017, there was an absolute risk reduction of 5.67% in a standard propensity matched comparison of SEP-1 compliant vs noncompliant care. With a more stringent match, the absolute risk reduction was 4.06%. That’s an outcome that our patients likely appreciate the most…lives saved.

As former CHEST President, Dr. Steven Simpson highlighted in his April 2022 commentary (CHEST Physician. 2022 April;17[4]:15), “Success is not dependent only on what we do but on when we do it.” Let’s not debate any further.

Namita Jayaprakash, MBBCh

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