Blood Cultures Performed in the Emergency Department Prior to Initial Antibiotic Received in Hospital (NQF 0148)
-
Initial Patient Population =
- AND: "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (discharge datetime)" during "Measurement period"
- AND: "Patient Characteristic: birth date" >= 18 year(s) starts before or during "Occurrence A of Encounter: Hospital Measures-Encounter
Inpatient (admission datetime)"
- AND: "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (length of stay <= 120 day(s))"
-
Denominator =
- AND: "Initial Patient Population"
- AND:
- OR: "Diagnosis, Active: Hospital Measures-Pneumonia (ordinality: 'Hospital Measures-Principal')" during "Occurrence A of Encounter:
Hospital Measures-Encounter Inpatient"
- OR:
- AND: "Diagnosis, Active: Hospital Measures-Septicemia (ordinality: 'Hospital Measures-Principal')" during "Occurrence A of
Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient"
- OR:
- AND: "Diagnosis, Active: Hospital Measures-Respiratory failure acute or chronic (ordinality: 'Hospital Measures-Principal')"
during "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient"
- AND:
- OR: "Diagnostic Study, Result: Hospital Measures-Chest xray (result: 'Hospital Measures-Radiological findings consistent with
pneumonia')" <= 1 day(s) starts before start of
- AND: "Occurrence A of Encounter: Hospital Measures-Encounter ED (facility location arrival)" starts before start of "Occurrence
A of Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Presumptive pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED"
- OR: "Diagnostic Study, Result: Hospital Measures-Chest xray (result: 'Hospital Measures-Radiological findings consistent with
pneumonia')" <= 24 hour(s) starts after end of
- AND: "Occurrence A of Encounter: Hospital Measures-Encounter ED (facility location arrival)" starts before start of "Occurrence
A of Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Presumptive pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED"
- OR: "Diagnostic Study, Result: Hospital Measures-CT scan including chest (result: 'Hospital Measures-Radiological findings
consistent with pneumonia')" <= 1 day(s) starts before start of
- AND: "Occurrence A of Encounter: Hospital Measures-Encounter ED (facility location arrival)" starts before start of "Occurrence
A of Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Presumptive pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED"
- OR: "Diagnostic Study, Result: Hospital Measures-CT scan including chest (result: 'Hospital Measures-Radiological findings
consistent with pneumonia')" <= 24 hour(s) starts after end of
- AND: "Occurrence A of Encounter: Hospital Measures-Encounter ED (facility location arrival)" starts before start of "Occurrence
A of Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Presumptive pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED"
- AND: "Laboratory Test, Performed: Hospital Measures-Blood culture" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED"
- AND: "Medication, Administered: Hospital Measures-IV or PO Antibiotics for pneumonia" <= 24 hour(s) starts after start of
"Occurrence A of Encounter: Hospital Measures-Encounter ED (facility location arrival)"
-
Denominator Exclusions =
- AND:
- OR: "Diagnosis, Active: Hospital Measures-Cystic fibrosis" starts before or during "Occurrence A of Encounter: Hospital Measures-Encounter
Inpatient"
- OR: "Diagnosis, Inactive: Hospital Measures-Cystic fibrosis" starts before or during "Occurrence A of Encounter: Hospital
Measures-Encounter Inpatient"
- OR:
- AND: "Patient Characteristic: Clinical trial participant" during "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient"
- AND: "Diagnosis, Active: Hospital Measures-Presumptive pneumonia" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED"
- OR: "Intervention, Performed: Hospital Measures-Comfort measure only intervention" <= 1 day(s) starts after start of ("Occurrence
A of Encounter: Hospital Measures-Encounter ED (facility location arrival)" starts before start of "Occurrence A of Encounter:
Hospital Measures-Encounter Inpatient")
- OR: "Transfer From: Hospital Measures-Ambulatory surgical center" < 1 day(s) starts before start of "Occurrence A of Encounter:
Hospital Measures-Encounter Inpatient"
- OR: "Transfer From: Hospital Measures-Acute care hospital" < 1 day(s) starts before start of "Occurrence A of Encounter:
Hospital Measures-Encounter Inpatient"
- OR: "Occurrence B of Encounter: Hospital Measures-Encounter ED" <= 1 day(s) starts before start of "Occurrence A of Encounter:
Hospital Measures-Encounter Inpatient"
- OR: "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (length of stay < 1 day(s))"
- OR: "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (discharge status: 'Hospital Measures-Left against medical
advice')" <= 1 day(s) starts after start of "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (admission
datetime)"
- OR: "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (discharge status: 'Hospital Measures-Expired')" <=
1 day(s) starts after start of "Occurrence A of Encounter: Hospital Measures-Encounter Inpatient (admission datetime)"
-
Numerator =
- AND: FIRST: "Medication, Administered: Hospital Measures-IV or PO Antibiotics for pneumonia" <= 24 hour(s) starts after
start of ("Laboratory Test, Performed: Hospital Measures-Blood culture" during "Occurrence A of Encounter: Hospital Measures-Encounter
ED")
-
Denominator Exceptions =
-
"Diagnosis, Active: Hospital Measures-Cystic fibrosis" using "Hospital Measures-Cystic fibrosis Value Set GROUPING (2.16.840.1.113883.3.666.05.682)"
-
"Diagnosis, Active: Hospital Measures-Pneumonia" using "Hospital Measures-Pneumonia ICD-9-CM Value Set (2.16.840.1.113883.3.666.05.756)"
-
"Diagnosis, Active: Hospital Measures-Presumptive pneumonia" using "Hospital Measures-Presumptive pneumonia SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1080)"
-
"Diagnosis, Active: Hospital Measures-Respiratory failure acute or chronic" using "Hospital Measures-Respiratory failure acute or chronic SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.673)"
-
"Diagnosis, Active: Hospital Measures-Septicemia" using "Hospital Measures-Septicemia Value Set GROUPING (2.16.840.1.113883.3.666.05.672)"
-
"Diagnosis, Inactive: Hospital Measures-Cystic fibrosis" using "Hospital Measures-Cystic fibrosis Value Set GROUPING (2.16.840.1.113883.3.666.05.682)"
-
"Diagnostic Study, Result: Hospital Measures-Chest xray" using "Hospital Measures-Chest xray SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.678)"
-
"Diagnostic Study, Result: Hospital Measures-CT scan including chest" using "Hospital Measures-CT scan including chest SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.680)"
-
"Encounter: Hospital Measures-Encounter ED" using "Hospital Measures-Encounter ED SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.627)"
-
"Encounter: Hospital Measures-Encounter Inpatient" using "Hospital Measures-Encounter Inpatient SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.625)"
-
"Intervention, Performed: Hospital Measures-Comfort measure only intervention" using "Hospital Measures-Comfort measure only intervention SNOMED-CT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
-
"Laboratory Test, Performed: Hospital Measures-Blood culture" using "Hospital Measures-Blood culture Value Set GROUPING (2.16.840.1.113883.3.666.05.681)"
-
"Medication, Administered: Hospital Measures-IV or PO Antibiotics for pneumonia" using "Hospital Measures-IV or PO Antibiotics for pneumonia RxNorm Value Set (2.16.840.1.113883.3.666.05.1093)"
-
"Patient Characteristic: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Patient Characteristic: Clinical trial participant" using "Clinical trial participant SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.643)"
-
"Transfer From: Hospital Measures-Acute care hospital" using "Hospital Measures-Acute care hospital SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.684)"
-
"Transfer From: Hospital Measures-Ambulatory surgical center" using "Hospital Measures-Ambulatory surgical center SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.687)"
-
Attribute: "Result: Hospital Measures-Radiological findings consistent with pneumonia" using "Hospital Measures-Radiological findings consistent with pneumonia SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1105)"
-
Attribute: "Ordinality: Hospital Measures-Principal" using "Hospital Measures-Principal SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.8001)"
-
Attribute: "Discharge status: Hospital Measures-Left against medical advice" using "Hospital Measures-Left against medical advice SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1106)"
-
Attribute: "Discharge status: Hospital Measures-Expired" using "Hospital Measures-Expired Value Set GROUPING (2.16.840.1.113883.3.666.05.1146)"
- "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"
- "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)"