Data AND REPORTING
Health services need robust sepsis data to understand the prevalence, recognition, responses and impact of sepsis on populations and health systems. However, the current quality and quantity of sepsis data is insufficient to provide a comprehensive picture so key strategies are aimed at:
1. Ensuring consistent documentation, reporting and coding of sepsis
2. Access to comprehensive contemporary data about patients with sepsis
3. Establishing an agreed minimum data set
4. Implementing data quality monitoring and improvement processes
Measuring sepsis and sepsis outcomes is challenging
Barriers include:
- Diagnosis of sepsis is difficult and inconsistently documented
- Different definitions of sepsis (for example Sepsis-3) and a large and complex number of differing sepsis codes
- Limitations of using ICD codes to study epidemiology including:
- Considerable variation in ICD codes used in the various sepsis ICD coding methods, thereby producing different sepsis estimates.
- Lack of consensus on the best set of ICD codes to study sepsis epidemiology as none of the available ICD coding methods has desirable diagnostic accuracy.
- Variation in coding practice:
- Clinical coders should only apply sepsis codes when a diagnosis of sepsis is clearly indicated in clinical notes or following consultation with clinicians to seek clarification, however a pilot study revealed that there is still considerable variation in practice.
- Explicit and implicit codes can indicate sepsis, but this is not well understood.
- Data gaps including data on sepsis recognition, management in primary care settings and comprehensive survival and mortality data. These gaps limit the ability to understand the patient journey through all parts of the health system and may lead to under-reporting
- No national sepsis data set or measurement framework
Current work on sepsis data
A national project will be undertaken in 2024/25 to improve the quality and quantity of sepsis data collection, coding and reporting so as to better understand the true burden of sepsis and to inform strategies aimed at improving early detection, treatment and outcomes.
The project will:
- Provide health services with current (updated) epidemiological data about sepsis based on current data availability
- Develop a national sepsis data plan that has focused, tangible and measurable goals to support quality improvement through the implementation of the Sepsis Clinical Care Standard (SCCS)
- Outline strategies to identify, store, package and integrate sepsis data
- Establish data governance, management and communication polices and mechanisms for effective data use
- Improve the consistency of sepsis recording and coding
- increase the availability and validity of national sepsis data
The project will be informed by research and quality improvement projects focused on strengthening sepsis data including:
- Data access including data governance and First Nations data governance
- Data linkage
- Clinical quality registries
- Sepsis reporting and visualisation
- Advancements in electronical medical record alert systems and patient identification systems to understand the patient journey
- Emerging trends in artificial intelligence and sepsis recognition
Recommendations will be generated on the criteria and processes required for a national sepsis measurement framework that can be leveraged for quality improvement, new or updated data collection and data reporting tools/guidance to support accurate sepsis data collection. The Epidemiology of Sepsis in Australian Public Hospitals 2020 report will be revised based on recommendations and including new tools.