eMeasure Title Venous Thromboembolism Discharge Instructions
eMeasure Identifier
(Measure Authoring Tool)
110 eMeasure Version number 1
NQF Number 0375 GUID 7fe69617-fa28-4305-a2b8-ceb6bcd9693d
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Joint Commission
Measure Developer Joint Commission
Endorsed By National Quality Forum
Description
This measure assesses the number of patients diagnosed with confirmed VTE that are discharged to home, home care, court/law enforcement or home on hospice care on warfarin with written discharge instructions that address all four criteria: compliance issues, dietary advice, follow-up monitoring, and information about the potential for adverse drug reactions/interactions.
Copyright
Measure specifications are in the Public Domain

LOINC(R) is a registered trademark of the Regenstrief Institute.

This material contains SNOMED Clinical Terms(R) (SNOMED CT(c)) copyright 2004-–2010 International Health Terminology Standards Development Organization. All rights reserved.
Disclaimer
None
Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
In the hospital, effective patient and family education is emerging as an important issue of health care in spite of inconsistent results related to patient outcomes. However, there is evidence that clear and understandable instructions given when the patients are ready to learn, can increase their satisfaction. Due to decreased length of stay, patients are discharged sooner with more complex medical conditions and need to be knowledgeable about their treatment and health care needs.

Anticoagulation therapy poses risks to patients and often leads to adverse drug events due to complex dosing, requisite follow-up monitoring and inconsistent patient compliance. The use of standardized practices for anticoagulation therapy that includes patient/caregiver involvement may reduce the risk of adverse drug events. The 2009 National Patient Safety Goal 3E, Implementation Expectation (M) C.10 states that the organization provides education regarding anticoagulation therapy to patients/family that includes the importance of follow-up monitoring, compliance issues, dietary restrictions, and potential for adverse drug reactions and interactions.
Clinical Recommendation Statement
Patients discharged to home on warfarin should be educated on and given written discharge instructions or other educational material regarding compliance issues, dietary advice, follow up monitoring and information about the potential for adverse drug reactions and interactions.
Improvement Notation
An increase in rate
Reference
Ansell J, Hirsch J, Hylek E, Jacobson A, Crowther M, Palareti G. Pharmacology and management of the vitamin K antagonists: The Eighth ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2008 133:160S-198S.
Reference
Leino-Kilpi H, Johansson K, Heikkinen K et al. Patient education and health- related quality of life: surgical hospital patients as a case in point. J Nurs Care Qual. 2005 Oct-Dec;20(4):307-16; quiz 317-8.
Reference
Oermann MH, Masserang M, Makey M et al. Clinic visit and waiting: patient education and satisfaction. Medsurg Nursing. 2002 Oct;11(5):247-50.
Definition
None
Guidance
The unit of measurement for this measure is an inpatient episode of care. Each distinct hospitalization should be reported, regardless of whether the same patient is admitted for inpatient care more than once during the measurement period. In addition, the eMeasure logic intends to represent events within or surrounding a single occurrence of an inpatient hospitalization.

Written information given to the patient is required to address each and every one of the educational components. Thes components are modeled in the population criteria and data criteria as communication from provider to patient: adverse reactions and interactions, INR monitoring and medication compliance, dietary advice and follow-up monitoring, and are intended to be specific to discharge instructions for warfarin therapy.
Transmission Format
None
Initial Patient Population
Patients with a diagnosis of venous thromboembolism (VTE), a patient age greater than or equal to 18 years, and a length of stay less than or equal to 120 days.
Denominator
Patients with confirmed VTE discharged to home or court/law enforcement on warfarin therapy.
Denominator Exclusions
Patients without VTE confirmed by diagnostic testing
Numerator
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:
1. compliance issues
2. dietary advice
3. follow-up monitoring
4. potential for adverse drug reactions and interactions
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
eMeasure Venous Thromboembolism (eVTE)