Primary PCI Received Within 90 Minutes of Hospital Arrival (NQF 0163)
-
Initial Patient Population =
- AND: "Diagnosis, Active: Hospital Measures-AMI (ordinality: 'Hospital Measures-Principal')"
- AND: "Patient Characteristic: birth date" >= 18 year(s) starts before start of "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- AND: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (length of stay <= 120 day(s))"
- AND: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (discharge datetime)" during "Measurement period"
-
Denominator =
- AND: "Initial Patient Population"
- AND:
- OR:
- AND: "Procedure, Performed: Hospital Measures-PCI" <= 24 hour(s) starts after start of "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED" starts before start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU
Inpatient locations')" starts before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility
location arrival datetime: 'Hospital Measures-ICU locations')"
- OR: "Procedure, Performed: Hospital Measures-PCI" <= 24 hour(s) starts after start of ("Occurrence A of Encounter: Hospital
Measures - Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')" starts before start of "Occurrence
A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')")
- OR: "Procedure, Performed: Hospital Measures-PCI" <= 24 hour(s) starts after start of ("Occurrence A of Encounter: Hospital
Measures - Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')" starts before start of "Occurrence
A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU Inpatient locations')")
- OR:
- AND: "Procedure, Performed: Hospital Measures-PCI" <= 24 hour(s) starts after start of ("Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-non-ICU Inpatient locations')" starts
before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU
locations')")
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED (facility location arrival datetime: 'Hospital Measures-ED
locations')" starts before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location:
'Hospital Measures-non-ICU Inpatient locations')"
- OR:
- AND: "Procedure, Performed: Hospital Measures-PCI" <= 24 hour(s) starts after start of ("Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')" starts before start
of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU Inpatient
locations')")
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED (facility location arrival datetime: 'Hospital Measures-ED
locations')" starts before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location:
'Hospital Measures-ICU locations')"
- OR:
- AND: "Procedure, Performed: Hospital Measures-PCI" <= 24 hour(s) starts after start of "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU Inpatient locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED" starts before start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')"
starts before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime:
'Hospital Measures-non-ICU Inpatient locations')"
- AND:
- OR: "Diagnostic Study, Result: Hospital Measures-ECG (result: 'ST-segment elevation', source: 'physician')" starts after start
of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR: "Diagnostic Study, Result: Hospital Measures-ECG (result: 'LBBB')" starts after start of "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Diagnostic Study, Result: Hospital Measures-ECG (result: 'Acute or evolving MI')" starts after start of "Occurrence A
of Encounter: Hospital Measures - Encounter Inpatient"
-
Denominator Exclusions =
- AND:
- OR: "Patient Characteristic: Clinical trial participant" during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Transfer from: Hospital Measures-Acute care hospital" starts before start of "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Transfer from: Hospital Measures-Ambulatory surgical center" 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: "Medication, Administered: Hospital Measures-Fibrinolytic Therapy" starts before start of (FIRST :"Procedure, Performed:
Hospital Measures-PCI" starts after start of
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU
locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-non-ICU
Inpatient locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient" <= 1 hour(s) starts after end of "Encounter: Hospital
Measures-Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
)
- OR: FIRST:"Procedure, Performed: Hospital Measures-PCI (ordinality: 'Secondary')" > 90 minute(s) starts after start of
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU
locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-non-ICU
Inpatient locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient" <= 1 hour(s) starts after end of "Encounter: Hospital
Measures-Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR: "Procedure, Performed: Hospital Measures-Aortic balloon pump insertion" <= 90 minute(s) starts after start of
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU
locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-non-ICU
Inpatient locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient" <= 1 hour(s) starts after end of "Encounter: Hospital
Measures-Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR: "Procedure, Performed: Hospital Measures-Endotrachael intubation" <= 90 minute(s) starts after start of
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU
locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-non-ICU
Inpatient locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient" <= 1 hour(s) starts after end of "Encounter: Hospital
Measures-Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR: "Diagnosis, Active: Hospital Measures-Cardiopulmonary arrest" <= 90 minute(s) starts after start of
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU
locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-non-ICU
Inpatient locations')"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient" <= 1 hour(s) starts after end of "Encounter: Hospital
Measures-Encounter ED (facility location arrival datetime: 'Hospital Measures-ED locations')"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
-
Numerator =
- AND:
- OR:
- AND: FIRST:"Procedure, Performed: Hospital Measures-PCI" <= 90 minute(s) starts after start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED" starts before start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU
Inpatient locations')" starts before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility
location arrival datetime: 'Hospital Measures-ICU locations')"
- OR: FIRST:"Procedure, Performed: Hospital Measures-PCI" <= 90 minute(s) starts after start of ("Occurrence A of Encounter:
Hospital Measures - Encounter ED (facility location departure datetime)" starts before start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')")
- OR: FIRST:"Procedure, Performed: Hospital Measures-PCI" <= 90 minute(s) starts after start of ("Occurrence A of Encounter:
Hospital Measures - Encounter ED (facility location departure datetime)" starts before start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU Inpatient locations')")
- OR:
- AND: FIRST:"Procedure, Performed: Hospital Measures-PCI" <= 90 minute(s) starts after start of ("Occurrence A of Encounter:
Hospital Measures - Encounter ED (facility location: 'Hospital Measures-non-ICU Inpatient locations')" starts before start
of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')")
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED (facility location departure datetime)" starts before
start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU
Inpatient locations')"
- OR:
- AND: FIRST:"Procedure, Performed: Hospital Measures-PCI" <= 90 minute(s) starts after start of ("Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')" starts before start of "Occurrence
A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU Inpatient locations')")
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED (facility location departure datetime)" starts before
start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')"
- OR:
- AND: FIRST:"Procedure, Performed: Hospital Measures-PCI" <= 90 minute(s) starts after start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-non-ICU Inpatient locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter ED" starts before start of "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient (facility location arrival datetime: 'Hospital Measures-ICU locations')"
- AND NOT: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location: 'Hospital Measures-ICU locations')"
starts before start of "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (facility location arrival datetime:
'Hospital Measures-non-ICU Inpatient locations')"
-
Denominator Exceptions =
-
"Diagnosis, Active: Hospital Measures-AMI" using "Hospital Measures-AMI Value Set GROUPING (2.16.840.1.113883.3.666.05.624)"
-
"Diagnosis, Active: Hospital Measures-Cardiopulmonary arrest" using "Hospital Measures-Cardiopulmonary arrest Value Set GROUPING (2.16.840.1.113883.3.666.05.748)"
-
"Diagnostic Study, Result: Hospital Measures-ECG" using "Hospital Measures-ECG Value Set GROUPING (2.16.840.1.113883.3.666.05.735)"
-
"Encounter: Hospital Measures-Encounter ED" using "Hospital Measures-Encounter ED SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.900)"
-
"Encounter: Hospital Measures-Encounter Inpatient" using "Hospital Measures-Encounter Inpatient SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.625)"
-
"Medication, Administered: Hospital Measures-Fibrinolytic Therapy" using "Hospital Measures-Fibrinolytic Therapy RxNorm Value Set (2.16.840.1.113883.3.666.05.736)"
-
"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)"
-
"Procedure, Performed: Hospital Measures-Aortic balloon pump insertion" using "Hospital Measures-Aortic balloon pump insertion SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1151)"
-
"Procedure, Performed: Hospital Measures-Endotrachael intubation" using "Hospital Measures-Endotrachael intubation SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.747)"
-
"Procedure, Performed: Hospital Measures-PCI" using "Hospital Measures-PCI SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.737)"
-
"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: "Ordinality: Hospital Measures-Principal" using "Hospital Measures-Principal SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.8001)"
-
Attribute: "Result: ST-segment elevation" using "Hospital Measures-ST-segment elevation ICD-10-CM Value Set (2.16.840.1.113883.3.666.05.1096)"
-
Attribute: "Result: LBBB" using "Hospital Measures-LBBB Value Set GROUPING (1.3.6.1.4.1.33895.1.3.0.8505)"
-
Attribute: "Result: Acute or evolving MI" using "Hospital Measures-Acute or evolving MI SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1098)"
-
Attribute: "Source: Physician" using "Hospital Measures-Physician SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1099)"
-
Attribute: "Ordinality: Secondary" using "Secondary SNOMED-CT Value Set (2.16.840.1.113883.3.67.1.101.1.951)"
-
Attribute: "Facility location: Hospital Measures-ICU locations" using "Hospital Measures-ICU locations HL7 Value Set (2.16.840.1.113883.3.666.05.1083)"
-
Attribute: "Facility location arrival datetime: Hospital Measures-ICU locations" using "Hospital Measures-ICU locations HL7 Value Set (2.16.840.1.113883.3.666.05.1083)"
-
Attribute: "Facility location: Hospital Measures-non-ICU Inpatient locations" using "Hospital Measures-non-ICU Inpatient locations HL7 Value Set (2.16.840.1.113883.3.666.05.1084)"
-
Attribute: "Facility location arrival datetime: Hospital Measures-non-ICU Inpatient locations" using "Hospital Measures-non-ICU Inpatient locations HL7 Value Set (2.16.840.1.113883.3.666.05.1084)"
-
Attribute: "Facility location: Hospital Measures-ED locations" using "Hospital Measures-ED locations SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.627)"
-
Attribute: "Facility location arrival datetime: Hospital Measures-ED locations" using "Hospital Measures-ED locations SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.627)"
- "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)"