AHRQ QI Measures

Based on AHRQ software: In-hospital deaths among discharges for low mortality (< 0.5%) Diagnosis Related Groups (DRGs) among patients ages 18 years and older or obstetric patients. Excludes cases with trauma, cases with cancer, cases with an immunocompromised state, and transfers to an acute care facility.

Download PSI 02 Specifications

Death in Low-Mortality DRGs Rate (PSI 2). In-hospital patient deaths in DRGs with less than 0.5% mortality

Based on AHRQ software: Stage III or IV pressure ulcers or unstageable (secondary diagnosis) among surgical or medical discharges ages 18 years and older. Excludes stays less than 3 days; cases with a principal stage III or IV (or unstageable) pressure ulcer diagnosis; cases with a secondary diagnosis of stage III or IV pressure ulcer (or unstageable) that is present on admission; obstetric cases; severe burns; exfoliative skin disorders.

Download PSI 03 Specifications

Count of Pressure Ulcer incidents divided by the number of encounters in the denominator (see specifications above).

Based on AHRQ software: In-hospital deaths among elective surgical discharges for patients ages 18 through 89 years or obstetric patients, with serious treatable complications (deep vein thrombosis / pulmonary embolism, pneumonia, sepsis, shock/cardiac arrest, or gastrointestinal hemorrhage/acute ulcer). Includes metrics for the number of discharges for each type of complication. Excludes cases transferred to an acute care facility and cases in hospice care at admission.

Download PSI 04 Specifications

Count of deaths among surgical inpatients divided by the number of encounters in the denominator (see specifications above).

Based on AHRQ software: The number of hospital discharges with a retained surgical item or unretrieved device fragment (secondary diagnosis) among surgical and medical patients ages 18 years and older or obstetric patients. Excludes cases with principal diagnosis of retained surgical item or unretrieved device fragment and cases with a secondary diagnosis of retained surgical item or unretrieved device fragment present on admission.

Download PSI 05 Specifications

Count of number of discharges with foreign body accidentally left in during procedure divided by the number of surgical encounters (see specifications above).

Based on AHRQ software: Iatrogenic pneumothorax cases (secondary diagnosis) among surgical and medical discharges for patients ages 18 years and older. Excludes cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic repair, or cardiac procedures; cases with a principal diagnosis of iatrogenic pneumothorax; cases with a secondary diagnosis of iatrogenic pneumothorax present on admission; and obstetric cases.

Download PSI 06 Specifications

Count of cases of iatrogenic pneumothorax divided by the number of encounters in the denominator (see specifications above).

Based on AHRQ software: Central venous catheter-related bloodstream infections (secondary diagnosis) among medical and surgical discharges for patients ages 18 years and older or obstetric cases. Excludes cases with a principal diagnosis of a central venous catheter-related bloodstream infection, cases with a secondary diagnosis of a central venous catheter-related bloodstream infection present on admission, cases with stays less than 2 days, cases with an immunocompromised state, and cases with cancer.

Download PSI 07 Specifications

Count of Central Venous Catheter-related Bloodstream Infections divided by the number of encounters in the denominator (see specifications above).

Based on AHRQ software: In hospital fall with hip fracture (secondary diagnosis) among discharges for patients ages 18 years and older. Excludes discharges with principal diagnosis of a condition with high susceptibility to falls (seizure disorder, syncope, stroke, occlusion of arteries, coma, cardiac arrest, poisoning, trauma, delirium or other psychoses, anoxic brain injury), diagnoses associated with fragile bone (metastatic cancer, lymphoid malignancy, bone malignancy), a principal diagnosis of hip fracture, a secondary diagnosis of hip fracture present on admission, and obstetric cases.

Download PSI 08 Specifications

Count of In-Hospital Postoperative Hip Fracture divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Perioperative hemorrhage or hematoma cases involving a procedure to treat the hemorrhage or hematoma, following surgery among surgical discharges for patients ages 18 years and older. Excludes cases with a diagnosis of coagulation disorder; cases with a principal diagnosis of perioperative hemorrhage or hematoma; cases with a secondary diagnosis of perioperative hemorrhage or hematoma present on admission; cases where the only operating room procedure is for treatment of perioperative hemorrhage or hematoma; obstetric cases.

Download PSI 09 Specifications

Count of postoperative cases of hematoma or hemorrhage requiring a procedure divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Postoperative acute kidney failure requiring dialysis among elective surgical discharges for patients ages 18 years and older. Excludes cases with principal diagnosis of acute kidney failure; cases with secondary diagnosis of acute kidney failure present on admission; cases with secondary diagnosis of acute kidney failure and dialysis procedure before or on the same day as the first operating room procedure; cases with acute kidney failure, cardiac arrest, severe cardiac dysrhythmia, cardiac shock, chronic kidney failure; a principal diagnosis of urinary tract obstruction and obstetric cases.

Download PSI 10 Specifications

Count of physiological or metabolic derangement cases divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Postoperative respiratory failure (secondary diagnosis), prolonged mechanical ventilation, or reintubation cases among elective surgical discharges for patients ages 18 years and older. Excludes cases with principal diagnosis for acute respiratory failure; cases with secondary diagnosis for acute respiratory failure present on admission; cases in which tracheostomy is the only operating room procedure or in which tracheostomy occurs before the first operating room procedure; cases with neuromuscular disorders; cases with laryngeal, oropharyngeal or craniofacial surgery involving significant risk of airway compromise; esophageal resection, lung cancer, lung transplant or degenerative neurological disorders; cases with respiratory or circulatory diseases; and obstetric discharges.

Download PSI 11 Specifications

Count of acute respiratory failure cases divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Perioperative pulmonary embolism or proximal deep vein thrombosis (secondary diagnosis) among surgical discharges for patients ages 18 years and older. Excludes discharges with a principal diagnosis of pulmonary embolism or proximal deep vein thrombosis; with a secondary diagnosis of pulmonary embolism or proximal deep vein thrombosis present on admission; in which interruption of the vena cava or a pulmonary arterial thromboectomy occurs before or on the same day as the first operating room procedure; with extracorporeal membrane oxygenation; with acute brain or spinal injury present on admission; and obstetric cases.

Download PSI 12 Specifications

Count of deep vein thrombosis (DVT) or pulmonary embolism (PE) cases divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Postoperative sepsis cases (secondary diagnosis) among elective surgical discharges for patients ages 18 years and older. Excludes cases with a principal diagnosis of sepsis, cases with a secondary diagnosis of sepsis present on admission, cases with a principal diagnosis of infection, cases with a secondary diagnosis of infection present on admission (only if they also have a secondary diagnosis of sepsis), obstetric discharges.

Download PSI 13 Specifications

Count of postoperative sepsis cases with a length of stay of 4 days or more divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Postoperative reclosures of the abdominal wall with a diagnosis of disruption of internal operational wound among abdominopelvic surgery discharges for patients ages 18 years and older. Excludes cases in which the abdominal wall reclosure occurs on or before the day of the first abdominopelvic surgery, cases with an immunocompromised state, cases with stays less than two (2) days, and obstetric cases.

Download PSI 14 Specifications

Count of postoperative disruption of abdominal wall cases with an abdominopelvic reclosure surgery divided by the number of surgical discharges (see specifications above).

Based on AHRQ software: Accidental punctures or lacerations (secondary diagnosis) among discharges for patients ages 18 years and older who have undergone an abdominopelvic procedure; in which a second abdominopelvic procedure follows one or more days after an index abdominopelvic procedure. Excludes cases with accidental puncture or laceration as a principal diagnosis, cases with accidental puncture or laceration as a secondary diagnosis that is present on admission, and obstetric cases.

Download PSI 15 Specifications

Cases of technical difficulty (e.g., accidental cut or laceration during procedure) divided by the number of surgical discharges (see above for specifications).

Based on AHRQ software: The number of medical and surgical discharges with a secondary diagnosis of transfusion reaction for patients ages 18 years and older or obstetric patients. Excludes cases with a principal diagnosis of transfusion reaction or cases with a secondary diagnosis of transfusion reaction that is present on admission. This measure has been retired by AHRQ, but is maintained in Axiom Clinical Analytics so you have historical data.

Download V7.0 PSI 16 Specifications (AHRQ website)

Count of transfusion reaction cases divided by the number of transfusion cases (see above for specifications).

Based on AHRQ software: Birth trauma injuries among newborns. Excludes preterm infants with a birth weight less than 2,000 grams, and cases with osteogenesis imperfecta.

Download PSI 17 Specifications

Count of birth trauma injury to neonate cases divided by the number of neonate encounters (see above for specifications).

Based on AHRQ software: Third and fourth degree obstetric traumas among instrument-assisted vaginal deliveries.

Download PSI 18 Specifications

Based on AHRQ software: Third and fourth degree obstetric traumas among vaginal deliveries. Excludes cases without instrument- assisted delivery.

Download PSI 19 Specifications

Count of all instances of PSIs 3, 6, 8, 9, 10, 11, 12, 13, 14, and 15. These are all of the PSIs included in the PSI-90 composite for Version 6.0.

Download PSI 90 Specifications

Sum of Numerators / (Sum of Expected Rate * Number of Cases for Each Measure for AHRQ Obstetrics PSI Measures).

PSI Measures Include: Obstetric Trauma - Vaginal Deliver with Instrument (PSI 18) and Obstetric Trauma - Vaginal Delivery without Instrument (PSI 19)

Sum of Numerators / (Sum of Expected Rate * Number of Cases for Each Measure for AHRQ PSI Measures).

PSI Measures Include: Death in Low Mortality DRGS (PSI 2), Pressure Ulcer (PSI 3), Failure to Rescue (PSI 4), Iatrogenic Pneumothorax (PSI 6), Selected Infections Due to Medical Care (PSI 7), Postoperative Hip Fracture (PSI 8)Postoperative Hemorrhage or Hematoma (PSI 9), Postoperative Physiologic and Metabolic Derangement (PSI 10), Postoperative Respiratory Failure (PSI 11), Postoperative PE or DVT (PSI 12), Postoperative Sepsis (PSI 13), Postoperative Wound Dehiscence (PSI 14), Accidental Puncture or Laceration (PSI 15)

PDI-1 - Accidental Puncture/Laceration Count

Based on AHRQ software: Accidental punctures or lacerations (secondary diagnosis) during procedure for patients ages 17 years and younger. Includes metrics for discharges grouped by risk category. Excludes obstetric discharges, spinal surgery discharges, discharges with accidental puncture or laceration as a principal diagnosis, discharges with accidental puncture or laceration as a secondary diagnosis that is present on admission, normal newborns, and neonates with birth weight less than 500 grams.

Download PDI 01 Specifications

Low

PDI-1 - Accidental Puncture/Laceration O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-2 - Pressure Ulcer Count

Based on AHRQ software: Stage III, IV, or unstageable pressure ulcers (secondary diagnosis) among surgical or medical patients 17 years of age and younger. Discharges are grouped by risk category. Includes metrics for discharges grouped by risk category. Excludes neonates; stays less than three (3) days; obstetric discharges; discharges with diseases of the skin; and discharges with principal diagnosis or secondary diagnosis present on admission for Stage III, IV or unstageable pressure ulcer.

Download v2018 PDI 02 Specifications (AHRQ website)

Low

PDI-2 - Pressure Ulcer O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-3 - Foreign Body Count

Based on AHRQ software: The number of hospital discharges with a retained surgical item or unretrieved device fragment (secondary diagnosis) among surgical and medical patients ages 17 years and younger. Excludes normal newborns, newborns with birth weight less than 500 grams, cases with principal diagnosis of retained surgical item or unretrieved device fragment, cases with a secondary diagnosis of retained surgical item or unretrieved device fragment present on admission, and obstetric cases.

Download v2018 PDI 03 Specifications (AHRQ website)

Low

PDI-5 - Iatrogenic Pneumothorax Count

Based on AHRQ software: Iatrogenic pneumothorax cases (secondary diagnosis) among surgical or medical discharges for patients ages 17 years and younger. Excludes normal newborns; neonates with a birth weight less than 500 grams; cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic surgery repair or cardiac surgery; cases with a principal diagnosis of iatrogenic pneumothorax; cases with a secondary diagnosis of iatrogenic pneumothorax present on admission; and obstetric cases.

Download PDI 05 Specifications

Low

PDI-5 - Iatrogenic Pneumothorax O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-6 - RACHS-1 Pediatric Heart Surgery Mortality Count

Based on AHRQ software: In-hospital deaths among pediatric heart surgery admissions for patients with congenital heart disease ages 17 years and younger. Excludes obstetric discharges; cases with transcatheter interventions as a single cardiac procedure, performed without bypass but with catheterization; cases with septal defect repairs as single cardiac procedures without bypass but with catheterization; cases with heart transplants; premature infants with patent ductus arteriosus (PDA) closure as the only cardiac procedure; age less than 30 days with PDA closure as only cardiac procedure; transfers to another hospital; cases with an unknown disposition; and neonates with birth weight less than 500 grams.

Download V6.0 PDI 06 Specifications (AHRQ website)

Low

PDI-6 - RACHS-1 Pediatric Heart Surgery Mortality Rate

Based on AHRQ software:  In-hospital deaths among pediatric heart surgery admissions for patients with congenital heart disease ages 17 years and younger, divided by the volume of such surgeries.

Low

PDI-7 - RACHS-1 Pediatric Heart Surgery Volume

Based on AHRQ software: The number of hospital discharges with a pediatric heart surgery procedure for patients with congenital heart disease ages 17 years and younger.

Download V6.0 PDI 07 Specifications (AHRQ website)

High

PDI-8 - Perioperative Hemorrhage or Hematoma Count

Based on AHRQ software: Perioperative hemorrhage or hematoma cases with control of perioperative hemorrhage or drainage of hematoma following surgery among elective surgical discharges for patients ages 17 years and younger. Includes metrics for discharges grouped by high and low risk. Excludes cases with a diagnosis of coagulation disorder; cases with a principal diagnosis of perioperative hemorrhage or hematoma; cases with a secondary diagnosis of perioperative hemorrhage or hematoma present on admission; cases where the only operating room procedure is control of perioperative hemorrhage, drainage of hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure; obstetric cases; and neonates with birth weight less than 500 grams.

Download PDI 08 Specifications

Low

PDI-8 - Perioperative Hemorrhage or Hematoma O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-9 - Post-Op Resp. Failure Count

Based on AHRQ software: Postoperative respiratory failure (secondary diagnosis), prolonged mechanical ventilation, or reintubation cases among elective surgical discharges for patients ages 17 and younger. Excludes cases with principal diagnosis for acute respiratory failure; cases with secondary diagnosis for acute respiratory failure present on admission; cases in which tracheostomy is the only operating room procedure or in which tracheostomy occurs before the first operating room procedure; cases with neuromuscular disorders or degenerative neurological disorders; cases with laryngeal, pharyngeal or craniofacial surgery; cases with craniofacial anomalies; cases with esophageal resection, lung cancer, lung transplant cases; cases with respiratory or circulatory diseases; and obstetric discharges.

Download PDI 09 Specifications

Low

PDI-9 - Post-Op Resp. Failure O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-10 - Post-Op Sepsis Count

Based on AHRQ software: Postoperative sepsis cases (secondary diagnosis) among surgery discharges for patients ages 17 years and younger. Includes metrics for discharges grouped by risk category. Excludes cases with a principal diagnosis of sepsis, cases with a secondary diagnosis of sepsis present on admission, cases with a principal diagnosis of infection (only if they also have a secondary diagnosis of sepsis), cases in which the procedure belongs to surgical class 4, neonates and obstetric discharges.

Download PDI 10 Specifications

Low

PDI-10 - Post-Op Sepsis O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-11 - Post-Op Wound Dehiscence Count

Based on AHRQ software: Postoperative reclosures of the abdominal wall among abdominopelvic surgery discharges for patients ages 17 years and younger. Excludes cases in which the abdominal wall reclosure occurs on or before the day of the first abdominopelvic surgery, newborn cases with gastroschisis or umbilical hernia repair occurring before the day of the abdominal wall reclosure, cases with a high- or intermediate-risk immunocompromised state, cases with cirrhosis and hepatic failure with a diagnosis of coma or hepatorenal syndrome, cases with transplants, cases with stays less than two (2) days, neonates with birth weight less than 500 grams, and obstetric cases.

Download v2018 PDI 11 Specifications (AHRQ website)

Low

PDI-11 - Post-Op Wound Dehiscence O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-12 - CR-BSIs Count

Based on AHRQ software: Central venous catheter-related bloodstream infections (secondary diagnosis) among medical and surgical discharges for patients ages 17 years and younger. Excludes cases with a principal diagnosis of a central venous catheter-related bloodstream infection, cases with a secondary diagnosis of a central venous catheter-related bloodstream infection present on admission, normal newborns, neonates with a birth weight of less than 500 grams, cases with stays less than two (2) days, and obstetric cases.

Download PDI 12 Specifications

Low

PDI-12 - CR-BSIs O/E

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

Low

PDI-13 - Transfusion Reaction Count

Based on AHRQ software: The number of medical and surgical discharges with a secondary diagnosis of transfusion reaction for patients ages 17 years and younger. Excludes cases with a principal diagnosis of transfusion reaction, cases with a secondary diagnosis of transfusion reaction that is present on admission, neonates, and obstetric cases.

Download v2018 PDI 13 Specifications (AHRQ website)

Low

Based on AHRQ software: Percent of discharges with a principal diagnosis of asthma. Excludes cases with a diagnosis code for cystic fibrosis and anomalies of the respiratory system, obstetric admissions, transfers from other institutions, and patients under 2 years or over 17.

Download PDI 14 Specifications

Low

Based on AHRQ software: Percent of discharges with a principal diagnosis of diabetes with short-term complications (ketoacidosis, hyperosmolarity, or coma). Excludes obstetric admissions, transfers from other institutions, and patients under 6 years or over 17.

Download PDI 15 Specifications

Low

Based on AHRQ software: Percent of discharges with a principal diagnosis of gastroenteritis, or with a principal diagnosis of dehydration with a secondary diagnosis of gastroenteritis. Excludes cases transferred from another facility, cases with gastrointestinal abnormalities or bacterial gastroenteritis, obstetric admissions, and patients under 3 months or over 17 years.

Download PDI 16 Specifications

Low

Based on AHRQ software: Percent of discharges with a principal diagnosis of urinary tract infection. Excludes cases with kidney or urinary tract disorders, cases with a high- or intermediate risk immunocompromised state (including hepatic failure and transplants), transfers from other institutions, obstetric admissions, and patients under 3 months or over 17 years.

Download PDI 18 Specifications

Low

Based on AHRQ software: Pediatric Quality Indicators (PDI) overall composite: Includes admissions for one of the following conditions: asthma, diabetes with short-term complications, gastroenteritis, or urinary tract infection. Excludes patients under 6 years or over 17.

Download PDI 90 Specifications

Low

Based on AHRQ software: Pediatric Quality Indicators (PDI) composite of acute conditions: Includes admissions for gastroenteritis or urinary tract infection. Excludes patients under 6 years or over 17.

Download PDI 91 Specifications

Low

Based on AHRQ software: Pediatric Quality Indicators (PDI) composite of chronic conditions: Includes admissions for asthma or diabetes with short-term complications. Excludes patients under 6 years or over 17.

Download PDI 92 Specifications

Low

Esophageal Resection Volume (IQI 1). Esophageal surgery is a rare procedure that requires technical proficiency; and errors in surgical technique or management may lead to clinically significant complications, such as sepsis, pneumonia, anastomotic breakdown, and death.

AHRQ has discontinued this measure as of V2019, so there is no longer volume measure data being calculated for this IQI.

Pancreatic Resection Volume (IQI 2). Pancreatic resection is a rare procedure that requires technical proficiency; and errors in surgical technique or management may lead to clinically significant complications, such as sepsis, anastomotic breakdown, and death.

AHRQ has discontinued this measure as of V2019, so there is no longer volume measure data being calculated for this IQI.

Abdominal Aortic Aneurysm (AAA) Repair Volume (IQI 4). AAA repair is a rare procedure that requires proficiency with the use of complex equipment; and technical errors may lead to clinically significant complications, such as arrhythmias, acute myocardial infarction, colonic ischemia, and death.

AHRQ has discontinued this measure as of V2019, so there is no longer volume measure data being calculated for this IQI.

Coronary Artery Bypass Graft Volume (IQI 5). Coronary artery bypass graft (CABG) requires proficiency with the use of complex equipment; and technical errors may lead to clinically significant complications, such as myocardial infarction, stroke, and death.

AHRQ has discontinued this measure as of V2019, so there is no longer volume measure data being calculated for this IQI.

Percutaneous Coronary Intervention (PCI) Volume. The number of hospital discharges with a procedure for percutaneous coronary intervention (PCI) for patients 18 years and older or obstetric patients.

Discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any-listed ICD-9-CM procedure codes for PCI.

Exclude cases: with missing gender (SEX=missing), age (AGE=missing), quarter (DQTR=missing), year (YEAR=missing), or principal diagnosis (DX1=missing).

AHRQ has discontinued this measure as of V2019, so there is no longer volume measure data being calculated for this IQI.

Carotid Endarterectomy (CEA) Volume (IQI 7). CEA is a common procedure that requires proficiency with the use of complex equipment; and technical errors may lead to clinically significant complications, such as abrupt carotid occlusion with or without stroke, myocardial infarction, and death. The definition for CEA mortality rate (IQI 31) is also noted below. The QI software calculates mortality for CEA, so that the volumes for this procedure can be examined in conjunction with mortality. However, the mortality measure should not be examined independently, because it did not meet the literature review and empirical evaluation criteria to stand alone as its own measure.

AHRQ has discontinued this measure as of V2019, so there is no longer volume measure data being calculated for this IQI.

Based on AHRQ software: In-hospital deaths among all discharges with a procedure for esophogeal resection or total gastrectomy and a diagnosis of esophageal cancer; or with a procedure for esophogeal resection and a diagnosis of gastrointestinal cancer, ages 18 years and older.

Esophageal cancer surgery is a rare procedure that requires technical proficiency; and errors in surgical technique or management may lead to clinically significant complications, such as sepsis, pneumonia, anastomotic breakdown, and death.

Based on AHRQ software: In-hospital deaths among all discharges with pancreatic resection, ages 18 years and older. Includes metrics to stratify discharges grouped by presence or absence of a diagnosis of pancreatic cancer. Excludes acute pancreatitis discharges, obstetric discharges, and transfers to another hospital.

Pancreatic resection is a rare procedure that requires technical proficiency; and errors in surgical technique or management may lead to clinically significant complications, such as sepsis, anastomotic breakdown, and death.

Based on AHRQ software: In-hospital deaths among all discharges with abdominal aortic aneurysm (AAA) repair, ages 18 years and older. Excludes obstetric discharges and transfers to another hospital.

Abdominal aortic aneurysm (AAA) repair is a relatively rare procedure that requires proficiency with the use of complex equipment; and technical errors may lead to clinically significant complications, such as arrhythmias, acute myocardial infarction, colonic ischemia, and death.

Based on AHRQ software: In-hospital deaths among all discharges with coronary artery bypass graft (CABG), ages 40 years and older. Excludes obstetric discharges and transfers to another hospital.

CABG is a common procedure that requires proficiency with the use of complex equipment; and technical errors may lead to clinically significant complications such as myocardial infarction, stroke, and death.

Based on AHRQ software: In-hospital deaths among all discharges with craniotomy, ages 18 years and older. Excludes patients with a principal diagnosis of head trauma and transfers to another short-term hospital.

Craniotomy for the treatment of subarachnoid hemorrhage or cerebral aneurysm entails high post-operative mortality rates.

Based on AHRQ software: In-hospital deaths among pelvic and thigh osteoarthrosis discharges with partial or full hip replacement, ages 18 years and older. Excludes hip fracture discharges, obstetric discharges, and transfers to another hospital.

Total hip arthroplasty (without hip fracture) is an elective procedure performed to improve function and relieve pain among patients with chronic osteoarthritis, rheumatoid arthritis, or other degenerative processes involving the hip joint.

Based on AHRQ software: In-hospital deaths among all discharges with acute myocardial infarction (AMI) as a principal diagnosis for patients ages 18 years and older. Excludes cases in hospice care at admission, obstetric discharges, and transfers to another hospital.

Timely and effective treatments for acute myocardial infarction (AMI), which are essential for patient survival, include appropriate use of thrombolytic therapy and revascularization.

Based on AHRQ software: In-hospital deaths among all discharges with heart failure as a principal diagnosis for patients ages 18 years and older. Excludes cases in hospice care at admission, obstetric discharges, and transfers to another hospital.

Congestive heart failure (CHF) is a progressive, chronic disease with substantial short-term mortality.

Based on AHRQ software: In-hospital deaths among all discharges with acute stroke as a principal diagnosis for patients ages 18 years and older. Includes metrics for discharges grouped by type of stroke. Excludes obstetric discharges, cases in hospice care at admission, and transfers to another hospital.

Quality treatment for acute stroke must be timely and efficient to prevent potentially fatal brain tissue death, and patients may not present until after the fragile window of time has passed.

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

The Expected values are not currently available from the AHRQ software, but are anticipated in early 2019, so AHRQ O/E measures are not available in Clinical Analytics for now.

Based on AHRQ software: In-hospital deaths among all discharges with a principal diagnosis of gastrointestinal hemorrhage; or a secondary diagnosis of esophageal varices with bleeding along with a qualifying associated principal diagnosis, for patients age 18 years and older. Excludes obstetric discharges, cases in hospice care at admission, discharges with a procedure for liver transplant, and transfers to another hospital.

Gastrointestinal (GI) hemorrhage may lead to death when uncontrolled, and the ability to manage severely ill patients with comorbidities may influence the mortality rate.

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

The Expected values are not currently available from the AHRQ software, but are anticipated in early 2019, so AHRQ O/E measures are not available in Clinical Analytics for now.

Based on AHRQ software: In-hospital deaths among all discharges with hip fracture as a principal diagnosis for patients ages 65 years and older. Excludes periprosthetic fracture discharges, obstetric discharges, cases in hospice care at admission, and transfers to another hospital.

Hip fractures, which are a common cause of morbidity and functional decline among elderly persons, are associated with a significant increase in the subsequent risk of mortality.

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

The Expected values are not currently available from the AHRQ software, but are anticipated in early 2019, so AHRQ O/E measures are not available in Clinical Analytics for now.

Based on AHRQ software: In-hospital deaths among all discharges with pneumonia as a principal diagnosis for patients ages 18 years and older. Excludes obstetric discharges, cases in hospice care at admission, and transfers to another hospital.

Treatment with appropriate antibiotics may reduce mortality, which is a leading cause of death in the United States.

Based on AHRQ software: Cesarean deliveries among all deliveries without a hysterotomy procedure. Excludes deliveries with complications (abnormal presentation, preterm delivery, fetal death, multiple gestation diagnoses, or breech procedure).

Cesarean delivery is the most common operative procedure performed in the United States and is associated with higher costs than vaginal delivery. Many organizations have aimed to monitor and reduce the rate.

Based on AHRQ software: Vaginal births among all deliveries by patients with previous Cesarean deliveries. Excludes deliveries with complications (abnormal presentation, preterm delivery, fetal death, multiple gestation diagnoses, or breech procedure).

The policy of recommending vaginal birth after Cesarean delivery (VBAC) represents to some degree a matter of opinion on the relative risks and benefits of a trial of labor in patients with previous Cesarean delivery.

Based on AHRQ software: Laparoscopic cholecystectomy discharges per 1,000 cholecystectomy discharges for patients with cholecystitis and/or cholelithiasis ages 18 years and older. Excludes obstetric discharges.

AHRQ has discontinued this measure as of V7.0, so there is no longer rate or O/E measure data available for this IQI.

Based on AHRQ software: Incidental appendectomy discharges per 1,000 hospital discharges with abdominal or pelvic surgery for patients ages 65 years and older. Excludes surgical removal of the colon (colectomy) or pelvic evisceration discharges, appendiceal cancer discharges, and obstetric discharges.

AHRQ has discontinued this measure as of V7.0, so there is no longer rate or O/E measure data available for this IQI.

Based on AHRQ software: Bilateral cardiac catheterization discharges per 1,000 heart catheterizations discharges for coronary artery disease for patients ages 18 years and older. Excludes valid indications for right-side catheterization discharges and obstetric discharges.

AHRQ has discontinued this measure as of V7.0, so there is no longer rate or O/E measure data available for this IQI.

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

The Expected values are not currently available from the AHRQ software, but are anticipated in early 2019, so AHRQ O/E measures are not available in Clinical Analytics for now.

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

The Expected values are not currently available from the AHRQ software, but are anticipated in early 2019, so AHRQ O/E measures are not available in Clinical Analytics for now.

Based on AHRQ software: In-hospital deaths among all discharges with a procedure for endarterectomy (CEA), for patients 18 years of age and older. Excludes obstetric discharges and transfers to another hospital.

CEA is a common procedure that requires proficiency with the use of complex equipment; and technical errors may lead to clinically significant complications, such as abrupt carotid occlusion with or without stroke, myocardial infarction, and death.

Based on AHRQ software: Observed count divided by the Expected number of incidents, where the Expected value is provided by the AHRQ software.

The Expected values are not currently available from the AHRQ software, but are anticipated in early 2019, so AHRQ O/E measures are not available in Clinical Analytics for now.

Based on AHRQ software: In-hospital deaths among all discharges with acute myocardial infarction (AMI) as a principal diagnosis for patients ages 18 years and older. Excludes obstetric discharges, transfers to another hospital, cases in hospice care at admission, and transfers in from another acute care hospital.

Timely and effective treatments for acute myocardial infarction (AMI), which are essential for patient survival, include appropriate use of thrombolytic therapy and revascularization.

Based on AHRQ software: First-time Cesarean deliveries without a hysterotomy procedure divided by total deliveries. Excludes deliveries with complications (abnormal presentation, preterm delivery, fetal death, multiple gestation diagnoses, or breech procedure).

Cesarean delivery is the most common operative procedure performed in the United States and is associated with higher costs than vaginal delivery. Many organizations have aimed to monitor and reduce the rate.