| eCQM Title | Intensive Care Unit Venous Thromboembolism Prophylaxis |
||
|---|---|---|---|
| eCQM Identifier (Measure Authoring Tool) | 190 | eCQM Version Number | 9.3.000 |
| NQF Number | Not Applicable | GUID | fa91ba68-1e66-4a23-8eb2-baa8e6df2f2f |
| Measurement Period | January 1, 20XX through December 31, 20XX | ||
| Measure Steward | The Joint Commission | ||
| Measure Developer | The Joint Commission | ||
| Endorsed By | None | ||
| Description |
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after the initial admission (or transfer) to the Intensive Care Unit (ICU) or surgery end date for surgeries that start the day of or the day after ICU admission (or transfer) |
||
| Copyright |
LOINC(R) copyright 2004-2019 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2019 International Health Terminology Standards Development Organisation. All Rights Reserved. Measure specifications are in the Public Domain |
||
| Disclaimer |
These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty. |
||
| Measure Scoring | Proportion | ||
| Measure Type | Process | ||
| Stratification |
None |
||
| Risk Adjustment |
None |
||
| Rate Aggregation |
None |
||
| Rationale |
Approximately two-thirds of cases of Deep Vein Thrombosis (DVT) or Pulmonary Emboli (PE) are associated with recent hospitalization. This is consistent with the 2001 report by Agency for Healthcare Research and Quality (Shojania et al., 2001). AHRQ reports that "the appropriate application of effective preventive measures in hospitals has major potential for improving patient safety, by reducing the incidence of VTE." Almost all hospitalized patients have at least one risk factor for Venous Thromboembolism (VTE), and approximately 40% have three or more risk factors. Without thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired DVT is approximately 10% to 40% among medical or general surgical patients and 40% to 60% following major orthopedic surgery (Geerts et al., 2008). Commonly, criteria for admission to the Intensive Care Unit (ICU) itself, puts patients at an increased risk for developing VTE, and subsequent increased risk of morbidity from PE. Some risk factors are related to the acute illness present that allowed for the admission to the ICU unit, and some risk factors may be acquired during the ICU admission due to subsequent medical treatments, for example limitations of mobility, presence of central venous lines or mechanical ventilation and subsequent pharmacological paralysis. Reports of DVT in the population of ICU patients vary in relation to the acuity of the illness in this population. DVT in ICU patients diagnosed with routine venography or Doppler ultrasound found ranges between 10% to 100%. Five studies prospectively screened patients who were not receiving thromboprophylaxis during their ICU stays. The rates of DVT using Fibrinogen Uptake Test, Doppler Ultrasound or venography ranged from 13 to 31% (Geerts et al., 2008). It is essential for all ICUs to assess each patient upon admission to the ICU unit, a change in level of status, for the need for VTE prophylaxis due to the above increased development of risk factors (Geerts et al., 2004). Some select surgeries have previously been monitored in the Surgical Care Improvement Project; since performance on these surgeries has achieved very high levels, they are not included in this measure. |
||
| Clinical Recommendation Statement |
Failure to recognize and protect patients at risk for venous thromboembolism (VTE) increases the chances for critically ill hospitalized patients for developing a deep vein thrombosis or dying from a pulmonary emboli. Screening all patients is the only evidence based practice in reducing incidence of disease. All intensive care unit (ICU) patients should be evaluated for primary VTE prophylaxis, and given appropriate prophylaxis when indicated. |
||
| Improvement Notation |
Improvement noted as an increase in rate |
||
| Reference |
Geerts, W. H., Bergqvist, D., Pineo, G. F., et al. (2008). Prevention of venous thromboembolism: The Eighth ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 133, 381S-453S. |
||
| Reference |
Geerts, W. H., Pineo, G. F., Heit, J. A., et al. (2004). Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 126(3 Suppl.), 338S-400S. |
||
| Reference |
Guyatt, G. H., Akl, E. A., Crowther, M., et al. (2012). Antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), 7S-47S. |
||
| Reference |
Kearon, C., Akl, E. A., Comerota, A. J., et al. (2012, February). Antithrombotic therapy for VTE disease: Antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), e419S-e494S. |
||
| Reference |
Shojania, K. G., Duncan, B. W., McDonald, D. M., et al. (eds.). (2001). Making health care safer: A critical analysis of patient safety practices. Evidence Report/Technology Assessment No. 43. Rockville, MD: Agency for Healthcare Research and Quality. |
||
| Reference |
Anderson, D. R., Morgano, G. P., Bennett, C., Dentali, F., Francis, C. W., Garcia, D. A., . . . Dahm, P. (2019). American Society of Hematology 2019 guidelines for management of venous thromboembolism: Prevention of venous thromboembolism in surgical hospitalized patients. Blood Advances, 3(23), 3898–3944. doi: 10.1182/bloodadvances.2019000975. |
||
| Definition |
None |
||
| Guidance |
The definition of an ICU for the purpose of the measures noted above is that used by the CDC in the NHSN Patient Safety Project. An intensive care unit can be defined as a nursing care area that provides intensive observation, diagnosis, and therapeutic procedures for adults and/or children who are critically ill. An ICU excludes nursing areas that provide step-down, intermediate care or telemetry only and specialty care areas. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis. Ambulation alone is not a sufficient reason for not administering VTE prophylaxis. In order for ambulation/patient ambulating to be considered as an acceptable reason, there needs to be explicit documentation, e.g., "patient out of bed and ambulating in halls - no VTE prophylaxis needed." This eCQM is an episode-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
||
| Transmission Format |
TBD |
||
| Initial Population |
Inpatient hospitalizations for patients age 18 and older, discharged from hospital inpatient acute care without a diagnosis of venous thromboembolism (VTE) or obstetrics with a length of stay less than or equal to 120 days that ends during the measurement period |
||
| Denominator |
Inpatient hospitalizations for patients directly admitted or transferred to ICU during the hospitalization |
||
| Denominator Exclusions |
* Inpatient hospitalizations for patients who have a hospital length of stay (LOS) less than 2 days * Inpatient hospitalizations for patients with comfort measures documented anytime between the day of arrival and the day after ICU admission or transfer * Inpatient hospitalizations for patients with comfort measures documented by the day after surgery end date for surgeries that end the day of or the day after hospital admission * Inpatient hospitalizations for patients with a principal procedure of surgical care improvement Project (SCIP) VTE selected surgeries that end the day of or the day after ICU admission or transfer |
||
| Numerator |
Inpatient hospitalizations for patients who received VTE prophylaxis: - the day of or the day after ICU admission (or transfer) - the day of or the day after surgery end date for surgeries that end the day of or the day after ICU admission (or transfer) Inpatient hospitalizations for patients who have documentation of a reason why no VTE prophylaxis was given: - between the day of arrival and the day after ICU admission (for patients directly admitted as inpatients to the ICU) - the day of or the day after surgery end date (for surgeries that end the day of or the day after ICU admission (or transfer) |
||
| Numerator Exclusions |
Not Applicable |
||
| Denominator Exceptions |
Inpatient hospitalizations for patients with ICU LOS less than one day |
||
| Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
||
"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions"
"Encounter With ICU Location"
"Encounter With ICU Location And Encounter Less Than 2 Days" union "Encounter With First ICU Stay With Principal Procedure of SCIP VTE Selected Surgery" union "Encounter With Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay" union "Encounter With Intervention Comfort Measures on Day of or Day After Procedure"
"Encounter With VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure"
union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure"
intersect ( "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE"
union "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery"
)
)
union "Encounter With Low Risk for VTE or Anticoagulant Administered"
union "Encounter With No VTE Prophylaxis Due to Medical Reason"
union "Encounter With No VTE Prophylaxis Due to Patient Refusal"
None
"Encounter With First ICU Location Stay Less Than 1 day"
None
Global."Inpatient Encounter" InpatientEncounter
where not ( exists ( InpatientEncounter.diagnoses EncounterDiagnoses
where ( EncounterDiagnoses.code in "Obstetrics"
or EncounterDiagnoses.code in "Venous Thromboembolism"
or EncounterDiagnoses.code in "Obstetrics VTE"
)
)
)
"Encounter With ICU Location"
"Encounter With First ICU Location Stay Less Than 1 day"
"Encounter With ICU Location And Encounter Less Than 2 Days" union "Encounter With First ICU Stay With Principal Procedure of SCIP VTE Selected Surgery" union "Encounter With Intervention Comfort Measures From Day Of Start of Hospitalization To Day After First ICU Stay" union "Encounter With Intervention Comfort Measures on Day of or Day After Procedure"
( Global."Inpatient Encounter" InpatientEncounter
with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of InpatientEncounter.relevantPeriod ) >= 18
)
intersect "Admission Without VTE or Obstetrical Conditions"
"Encounter With ICU Location" QualifyingEncounterICU where Global."LengthInDays" ( VTEICU."FirstICULocationPeriod" ( QualifyingEncounterICU ) ) < 1
"Encounter With ICU Location" QualifyingEncounterICU
with ( "SCIP VTE Selected Surgery" Procedure
where Procedure.rank = 1 ) SelectedSCIPProcedure
such that SelectedSCIPProcedure.relevantPeriod ends during TJC."CalendarDayOfOrDayAfter" ( VTEICU."StartOfFirstICU" ( QualifyingEncounterICU ) )
"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
where exists ( QualifyingEncounter.facilityLocations Location
where Location.code in "Intensive Care Unit"
and Location.locationPeriod during QualifyingEncounter.relevantPeriod
)
"Encounter With ICU Location" QualifyingEncounterICU where Global."LengthInDays" ( QualifyingEncounterICU.relevantPeriod ) < 2
"Encounter With ICU Location" QualifyingEncounterICU
with "Intervention Comfort Measures" ComfortMeasures
such that Coalesce(start of ComfortMeasures.relevantPeriod, ComfortMeasures.authorDatetime)during VTEICU."FromDayOfStartOfHospitalizationToDayAfterFirstICU" ( QualifyingEncounterICU )
from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Intervention Comfort Measures" ComfortMeasures
where AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and Coalesce(start of ComfortMeasures.relevantPeriod, ComfortMeasures.authorDatetime)during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
"Low Risk for VTE or Anticoagulant Administered From Day of Start of Hospitalization To Day After First ICU Stay" union "Low Risk for VTE or Anticoagulant Administered on Day of or Day After Procedure"
( "Encounter With ICU Location" QualifyingEncounterICU
with ["Medication, Administered": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
such that FactorXaMedication.relevantPeriod starts during TJC."CalendarDayOfOrDayAfter" ( VTEICU."StartOfFirstICU" ( QualifyingEncounterICU ) )
)
union ( from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
["Medication, Administered": "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"] FactorXaMedication
where AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and FactorXaMedication.relevantPeriod starts during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
)
( "No VTE Prophylaxis Medication Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay"
intersect "No VTE Prophylaxis Device Due to Medical Reason From Day Of Start of Hospitalization To Day After First ICU Stay"
)
union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"
intersect "No VTE Prophylaxis Device Due to Medical Reason on Day of or Day After Procedure"
)
"No VTE Prophylaxis Due to Patient Refusal From Day Of Start of Hospitalization To Day After First ICU Stay" union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"
( "Encounter With ICU Location" QualifyingEncounterICU
with ["Diagnosis": "Atrial Fibrillation/Flutter"] AtrialFibrillation
such that AtrialFibrillation.prevalencePeriod starts on or before
end of QualifyingEncounterICU.relevantPeriod
)
union ( "Encounter With ICU Location" QualifyingEncounterICU
where exists ( QualifyingEncounterICU.diagnoses QualifyingEncounterDiagnoses
where QualifyingEncounterDiagnoses.code in "Atrial Fibrillation/Flutter"
)
)
union ( "Encounter With ICU Location" QualifyingEncounterICU
with ["Diagnosis": "Venous Thromboembolism"] VTEDiagnosis
such that VTEDiagnosis.prevalencePeriod starts before start of QualifyingEncounterICU.relevantPeriod
)
"Encounter With ICU Location" QualifyingEncounterICU
with ( ["Procedure, Performed": "Hip Replacement Surgery"]
union ["Procedure, Performed": "Knee Replacement Surgery"] ) HipKneeProcedure
such that HipKneeProcedure.relevantPeriod starts on or before
end of QualifyingEncounterICU.relevantPeriod
( "Encounter With ICU Location" QualifyingEncounterICU
with "VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis
such that VTEProphylaxis.relevantPeriod starts during TJC."CalendarDayOfOrDayAfter" ( VTEICU."StartOfFirstICU" ( QualifyingEncounterICU ) )
)
union ( from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis
where AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and VTEProphylaxis.relevantPeriod starts during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
)
"Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions"
["Intervention, Order": "Comfort Measures"] union ["Intervention, Performed": "Comfort Measures"]
"Encounter With ICU Location" QualifyingEncounterICU
with "Low Risk Indicator For VTE" LowRiskForVTE
such that LowRiskForVTE.LowRiskDatetime during VTEICU."FromDayOfStartOfHospitalizationToDayAfterFirstICU" ( QualifyingEncounterICU )
from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"Low Risk Indicator For VTE" LowRiskForVTE
where AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and LowRiskForVTE.LowRiskDatetime during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
/*The variable "LowRiskDatetime" is to hold VTE Risk Assessment relevant dateTime, INR Laboratory Test result dateTime, and Anticoagulant Medication administration start dateTime.
*/
( ["Assessment, Performed": "Risk for venous thromboembolism"] VTERiskAssessment
where VTERiskAssessment.result in "Low Risk"
return {
id: VTERiskAssessment.id,
LowRiskDatetime: VTERiskAssessment.relevantDatetime
}
)
union ( ["Laboratory Test, Performed": "INR"] INRLabTest
where INRLabTest.result > 3.0
return {
id: INRLabTest.id,
LowRiskDatetime: INRLabTest.resultDatetime
}
)
union ( ( ( ["Medication, Administered": "Unfractionated Heparin"] UnfractionatedHeparin
where UnfractionatedHeparin.route in "Intravenous route"
)
union ["Medication, Administered": "Direct Thrombin Inhibitor"]
union ["Medication, Administered": "Glycoprotein IIb/IIIa Inhibitors"] ) AnticoagulantMedication
return {
id: AnticoagulantMedication.id,
LowRiskDatetime: start of AnticoagulantMedication.relevantPeriod
}
)
["Encounter, Performed": "Encounter Inpatient"] EncounterInpatient where "LengthInDays"(EncounterInpatient.relevantPeriod)<= 120 and EncounterInpatient.relevantPeriod ends during "Measurement Period"
["Device, Not Applied": "Intermittent pneumatic compression devices (IPC)"] union ["Device, Not Applied": "Venous foot pumps (VFP)"] union ["Device, Not Applied": "Graduated compression stockings (GCS)"] union ["Device, Not Ordered": "Intermittent pneumatic compression devices (IPC)"] union ["Device, Not Ordered": "Venous foot pumps (VFP)"] union ["Device, Not Ordered": "Graduated compression stockings (GCS)"]
"Encounter With ICU Location" QualifyingEncounterICU
with "No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice
such that NoVTEDevice.negationRationale in "Medical Reason"
and NoVTEDevice.authorDatetime during VTEICU."FromDayOfStartOfHospitalizationToDayAfterFirstICU" ( QualifyingEncounterICU )
from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No VTE Prophylaxis Device Applied or Ordered" NoVTEDevice
where NoVTEDevice.negationRationale in "Medical Reason"
and AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and NoVTEDevice.authorDatetime during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
"Encounter With ICU Location" QualifyingEncounterICU
with "No VTE Prophylaxis Medication or Device Due to Patient Refusal" PatientRefusal
such that PatientRefusal.authorDatetime during VTEICU.FromDayOfStartOfHospitalizationToDayAfterFirstICU ( QualifyingEncounterICU )
from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No VTE Prophylaxis Medication or Device Due to Patient Refusal" PatientRefusal
where AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and PatientRefusal.authorDatetime during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
["Medication, Not Administered": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] union ["Medication, Not Administered": "Low Molecular Weight Heparin for VTE Prophylaxis"] union ["Medication, Not Administered": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] union ["Medication, Not Administered": "Warfarin"] union ["Medication, Not Administered": "Rivaroxaban and Betrixaban for VTE Prophylaxis"] union ["Medication, Not Ordered": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] union ["Medication, Not Ordered": "Low Molecular Weight Heparin for VTE Prophylaxis"] union ["Medication, Not Ordered": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"] union ["Medication, Not Ordered": "Warfarin"] union ["Medication, Not Ordered": "Rivaroxaban and Betrixaban for VTE Prophylaxis"]
"Encounter With ICU Location" QualifyingEncounterICU
with "No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedicaion
such that NoVTEMedicaion.negationRationale in "Medical Reason"
and NoVTEMedicaion.authorDatetime during VTEICU."FromDayOfStartOfHospitalizationToDayAfterFirstICU" ( QualifyingEncounterICU )
from
"Encounter With ICU Location" QualifyingEncounterICU,
["Procedure, Performed": "General or Neuraxial Anesthesia"] AnesthesiaProcedure,
"No VTE Prophylaxis Medication Administered or Ordered" NoVTEMedication
where NoVTEMedication.negationRationale in "Medical Reason"
and AnesthesiaProcedure.relevantPeriod ends 1 day after day of VTEICU."StartOfFirstICU" ( QualifyingEncounterICU )
and NoVTEMedication.authorDatetime during TJC."CalendarDayOfOrDayAfter" (
end of AnesthesiaProcedure.relevantPeriod )
return QualifyingEncounterICU
( "No VTE Prophylaxis Medication Administered or Ordered" union "No VTE Prophylaxis Device Applied or Ordered" ) NoVTEProphylaxis where NoVTEProphylaxis.negationRationale in "Patient Refusal"
"Encounter With VTE Prophylaxis Received on Day of or Day After First ICU Stay or Procedure"
union ( "Encounter With Medication Oral Factor Xa Inhibitor Administered on Day of or Day After First ICU Stay or Procedure"
intersect ( "Encounter With Prior or Present Diagnosis of Atrial Fibrillation or VTE"
union "Encounter With Prior or Present Procedure of Hip or Knee Replacement Surgery"
)
)
union "Encounter With Low Risk for VTE or Anticoagulant Administered"
union "Encounter With No VTE Prophylaxis Due to Medical Reason"
union "Encounter With No VTE Prophylaxis Due to Patient Refusal"
//'SCIP' stands for Surgical Care Improvement Project ["Procedure, Performed": "General Surgery"] union ["Procedure, Performed": "Gynecological Surgery"] union ["Procedure, Performed": "Hip Fracture Surgery"] union ["Procedure, Performed": "Hip Replacement Surgery"] union ["Procedure, Performed": "Intracranial Neurosurgery"] union ["Procedure, Performed": "Knee Replacement Surgery"] union ["Procedure, Performed": "Urological Surgery"]
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
( ["Medication, Administered": "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
where VTEMedication.route in "Subcutaneous route"
)
union ["Medication, Administered": "Low Molecular Weight Heparin for VTE Prophylaxis"]
union ["Medication, Administered": "Injectable Factor Xa Inhibitor for VTE Prophylaxis"]
union ["Medication, Administered": "Warfarin"]
union ["Medication, Administered": "Rivaroxaban and Betrixaban for VTE Prophylaxis"]
union ["Device, Applied": "Intermittent pneumatic compression devices (IPC)"]
union ["Device, Applied": "Venous foot pumps (VFP)"]
union ["Device, Applied": "Graduated compression stockings (GCS)"]
years between ToDate(BirthDateTime)and ToDate(AsOf)
First((Encounter.facilityLocations)HospitalLocation
where HospitalLocation.code in "Intensive Care Unit"
and HospitalLocation.locationPeriod during Encounter.relevantPeriod
sort by start of locationPeriod
)
Encounter Visit let ObsVisit: Last(["Encounter, Performed": "Observation Services"] LastObs where LastObs.relevantPeriod ends 1 hour or less on or before start of Visit.relevantPeriod sort by end of relevantPeriod ), VisitStart: Coalesce(start of ObsVisit.relevantPeriod, start of Visit.relevantPeriod), EDVisit: Last(["Encounter, Performed": "Emergency Department Visit"] LastED where LastED.relevantPeriod ends 1 hour or less on or before VisitStart sort by end of relevantPeriod ) return Interval[Coalesce(start of EDVisit.relevantPeriod, VisitStart), end of Visit.relevantPeriod]
difference in days between start of Value and end of Value
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
Interval[Global."ToDate" ( StartValue ), Global."ToDate" ( StartValue + 2 days ) )
Global."FirstInpatientIntensiveCareUnit" ( Encounter ).locationPeriod
Interval[Global."ToDate"(start of Global."HospitalizationWithObservation"(Encounter)), Global."ToDate"(StartOfFirstICU(Encounter)+ 2 days))
start of "FirstICULocationPeriod"(Encounter)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
| Measure Set |
eMeasure Venous Thromboembolism (eVTE) |
||
|---|---|---|---|