The New VTE Measures. Kathy Phipps, RN, BSN March 14, 2013
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1 The New VTE Measures Kathy Phipps, RN, BSN March 14, 2013
2 VTE Initial Patient Population VTE measure set: unique in having three distinct Initial Patient Populations (or sub-populations) within the measure set, each identified by a specific group of diagnosis codes, or lack thereof. All three sub-populations include inpatient discharges who are >= 18 years of age and have a Length of Stay (LOS) <= 120 days. 2
3 VTE Initial Patient Population Sampling The three sub-populations must be sampled independently from each other and have their own sampling requirements. Sub-population 1 and Sub-population 2 can be sampled Sub-population 3 cannot be sampled; must submit 100% of the population 3
4 VTE Initial Patient Population Sub-populations (slide 1 of 2) No VTE (sub-population 1) Includes patients with any ICD-9-CM diagnosis code (Principal or Other) except patients with a diagnosis of Obstetrics (Table 7.02), VTE (Table 7.03), or Obstetrics-VTE (Table 7.04). If the patient has a Principal or Other ICD-9-CM diagnosis code of Obstetrics, VTE, or Obstetrics-VTE, they are not included in the No VTE sub-population. Principal VTE (sub-population 2) Includes patients with an ICD-9-CM Principal diagnosis of VTE or Obstetrics-VTE 4
5 VTE Initial Patient Population Sub-populations (slide 2 of 2) Other VTE Only (sub-population 3) Patients with an ICD-9-CM Other diagnosis code of VTE or Obstetrics-VTE 5
6 VTE Initial Patient Population Overview VTE Patients >= 18 years of age with a LOS <= 120 days and any ICD-9-CM Diagnosis Code 6
7 VTE Initial Patient Population Population Inclusions/Exclusions VTE Measures VTE Measure Information Forms can be located in the Specifications Manual on QualityNet by selecting VTE (direct link): %2FQnetTier4&cid=
8 VTE Measures VTE-1 Venous Thromboembolism Prophylaxis VTE-2 Intensive Care Unit Venous Thromboembolism Prophylaxis VTE-3 Venous Thromboembolism Patients with Anticoagulation Overlap Therapy 8
9 VTE Measures (continued) VTE-4 Venous Thromboembolism Patients Receiving Unfractionated Heparin with Dosages/Platelet Count Monitoring by Protocol or Nomogram VTE-5 Venous Thromboembolism Warfarin Therapy Discharge Instructions VTE-6 Hospital Acquired Potentially-Preventable Venous Thromboembolism 9
10 VTE-1 Patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given: The day of or the day after hospital admission The day of or the day after surgery end date for surgeries that start the day of or the day after hospital admission 10
11 VTE-2 Patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given: The day of or the day after ICU admission (or transfer) The day of or the day after surgery end date for surgeries that start the day of or the day after ICU admission (or transfer) 11
12 VTE-3 Assesses the number of patients diagnosed with confirmed VTE who received an overlap of parenteral (intravenous or subcutaneous) anticoagulation and warfarin therapy. 12
13 VTE-4 Patients who have their IV Unfractionated Heparin (UFH) therapy dosages AND platelet counts monitored according to defined parameters such as a nomogram or protocol. 13
14 VTE-5 Patients with documentation that they or their caregivers were given written discharge instructions or other educational material about warfarin that addressed all of the following: Compliance issues Dietary advice Follow-up monitoring Potential for adverse drug reactions and interactions 14
15 VTE-6 Assesses the number of patients diagnosed with confirmed VTE during hospitalization (not present at admission) who received no VTE prophylaxis between hospital admission and the day before the VTE diagnostic testing order date. This is a reverse or negative measure Want the numerator to be low. 15
16 VTE-6 Measure Outcome 16
17 Contacts Kathy Phipps, RN, BSN QI Specialist or Cheryl Prahl Project Assistant or Adapted from content originally developed by Telligen. This material was prepared by Acumentra Health, Oregon s Medicare Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10SOW-OR-QRI /14/13 17
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