Functional Area / Diagnosis or Application
Indicator / Standard
ED- Cardiac Chest Pain/AMI
Median time from arrival in ED to ECG for patients treated in ED and/or transferred / Median time On arrival if +for suspected cardiogenic chest pain-
Within 10 minutes / CMS and OPPS Rule
Aspirin / Unless contraindicated upon arrival or
within 24 hours of admission / CMS and OPPS Rule
Median time to thrombolytics from arrival in ED for patients treated then transferred / OPPS Rule – sample size will be too small
Median time from ED arrival to transfer for primary percutaneous coronary intervention / Median time / Sample size will be too small
Transfer Communications / Office of Rural Health Policy,
Flex Monitoring Team
Administrative Information / RN communication with receiving hospital RN/staff / Documented on transfer / Office of Rural Health Policy,
Flex Monitoring Team
Physician communication with receiving physician / Documented on transfer / Office of Rural Health Policy,
Flex Monitoring Team
Patient Information – face-sheet
Name, address, age, gender, contact Information, insurance Information / Documented on transfer / Office of Rural Health Policy,
Flex Monitoring Team
Patient Information / Diagnosis/Indicator / Documented on transfer / Office of Rural Health Policy,
Flex Monitoring Team
Functional Area
Vital Signs / 1) Pulse
2) Respiration
3) Blood pressure
4) Temperature
5) Pulse O2 level
6) Glasgow score
7) Apgar score (if applicable) / Monitoring after arrival
Documented on transfer / Office of Rural Health Policy,
Flex Monitoring Team
Medication Communication / 1) Medication history (Med Reconciliation)
2) Medications Given (MAR)
3) Allergies / Documented on Transfer / Office of Rural Health Policy,
Flex Monitoring Team
Physician Documentation / 1) Physician’s history and physical
2) Physician’s orders and reason for transfer / Documented on Transfer / Office of Rural Health Policy,
Flex Monitoring Team
Nursing Documentation / Nurse documentation:
1)Assessment
2)Interventions/response / Documented on Transfer / Office of Rural Health Policy,
Flex Monitoring Team
Tests and Procedures / Tests and procedures done
(copies as indicated) / Documented on Transfer / Office of Rural Health Policy,
Flex Monitoring Team
Community-Acquired Pneumonia
Inpatient / Appropriate empiric antibiotic prescribed for community-acquired bacterial pneumonia* / CMS
Patients aged 65+ screened for pneumococcal vaccine and were administered Pneumovax before discharge, if indicated / Percent of total CAP patients / CMS
Patients age 50 years and older, hospitalized during October, November, December, January, February, or March who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated. / Percent of total CAP patients / CMS
Patients who were transferred or admitted to the intensive care unit (ICU) or to hospital within 24 hours of hospital arrival, who had blood cultures performed within 24 hours prior to or 24 hours after hospital arrival. / Percent of total CAP patients / CMS
Patient with oxygen saturation assessed / Percent of total CAP patients / CMS
Patients who received smoking cessation intervention / Percent of total CAP patients / CMS
Patients who receive their first dose of antibiotic within 6 hours of arriving at hospital / Percent of total CAP patients / CMS
Time to antibiotic after first arriving to hospital / Percent of total CAP patients / CMS
Patients whose initial ED blood culture specimen was collected prior to first hospital dose of antibiotics. / Median Time / CMS
CHF Inpatient
Discharge Instructions / Adult patients with a primary diagnosis of heart failure discharged home with written instructions or educational material given to the patient or his or her caregiver at discharge or during the hospital stay, addressing all of the following:
- activity level
- diet
- discharge medications
- follow-up appointment
- weight monitoring, and
- what to do if symptoms worsen
(Documented on Discharge) / CMS
ASA on Discharge / Percent of adult patients w/ HF / CMS
Patients with documented Left Ventricular Systolic (LVS) Function / Percent of adult patients with HF / CMS
Angiotensin-converting enzyme inhibitor(s )(ACEI) or ARB for Left Ventricular Systolic Dysfunction (LVSD) / Percent of adult patients with HF / CMS
Adult Smoking Cessation Advice/Counseling / Percent of adult patients with HF / CMS
Inpatient Units: Medical, Surgical, OB (other options: ED, ambulatory care, specific inpatient departments ) / Patient Experience / National Quality Measures Clearing House/AHRQ
CHART / CMS – may not have adequate sample size in each category (medical, surgical, OB)
Overall Experience / Mean Score
Admission
Nursing Care
Tests and Treatments
Care Environment
Meals
Physician care
Discharge
Appendix 1
UCSF-PRL IHPS-CHA CHART Project, NLO