Quality Improvement in Infection COntrol and Sepsis Management in MOdel Regions (icosmos)

Center for Sepsis Control and Care, Germany

Status: Completed

Conditions: Severe Sepsis; Septic Shock; Sepsis

Treatments: Other: structured case analysis; Other: strucured screening "every patient, every shift"

Study type: Interventional

Funder types: Other

Identifiers

NCT02820675

CSCCGermany

Details and patient eligibility

About

The German Quality Network Sepsis is an association trying to improve quality of care for patients with sepsis, severe sepsis and septic shock or being in risc thereof.

The icosmos trial investigates the impact on the use of routine data, a risk adjustment algorithm and feedback to all hospitals as well as a structured implementation for regular screening for deteriorating patients, and education on in-hospital mortality.

Full description

All German hospitals provide a set of routine data to federal adminsitration for reimbursement. This dataset includes all ICD-10-Codes (German adaption) as well as all procedure codes.

This dataset is pseudonomized and risk adjusted for every individual case and afterwards feedbacked to each participating hospital including all accumulated data from all other hospitals as well as the German Average for sepsis mortalities provided by the German Federal Institute of Statistcs for benchmarkings.

Based on this data, the icosmos trial will provide support to all participating hospitals for two major strategies to be implemented

1. An algorithm for structured analysis of

   1. low-risk-fatalities as potentially preventable deaths for underlying problems in diagnosis, treatment, etc
   2. high-risk-survivors as "best practice"
   3. coding errors for improvement of coding quality

2. a structured sreening program of every patient on every ward in every shift for deterioration and support algorithms including consiliary support and outreach teams as well as structured education

The icosmos trial will investigate the effects as well on quality of coding and sepsis incidence as well as on sepsis-related sepsis in-hospital mortality for participating hospitals in comparison to the German Average.

Enrollment: 70 patients

Sex: All

Ages: 16+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for hospitals:

• hospitals willing to participate

Inclusion Criteria for patients / patients' data

• age over 16
• coding of sepsis, severe sepsis, septic shock

Exclusion Criteria for hospitals:

• no intensive care unit on site

Trial design

Primary purpose: Health Services Research

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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70 participants in 1 patient group

intervention

Other group

Description:

all hospitals participating in the icosmos trial will be supported in implenatation of the two main interventions.

Treatment:

Other: structured case analysis

Other: strucured screening "every patient, every shift"