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Hospital Harm - Severe Hypoglycemia

Compare Versions of: "Hospital Harm - Severe Hypoglycemia"

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Measure Information 2023 Reporting Period 2024 Reporting Period
Title Hospital Harm - Severe Hypoglycemia Hospital Harm - Severe Hypoglycemia
CMS eCQM ID CMS816v2 CMS816v3
Short Name

HH-01

HH-Hypo

NQF Number 3503e 3503e
Description

Inpatient hospitalizations for patients 18 years of age or older at admission, who were administered at least one hypoglycemic medication during the encounter, who suffer the harm of a severe hypoglycemic event during the encounter

The measure assesses the number of inpatient hospitalizations for patients age 18 and older who were administered at least one hypoglycemic medication during the encounter, who suffer the harm of a severe hypoglycemic event during the encounter

Initial Population

Inpatient hospitalizations where the patient is 18 years of age or older at the start of the encounter, and at least one hypoglycemic medication was administered during the encounter.

The measure includes instances of administration of hypoglycemic medications in the emergency department or in observation status at the start of an inpatient hospitalization when assessing inclusion of encounters in the measure denominator.

Inpatient hospitalizations that end during the measurement period for patients age 18 and older and at least one hypoglycemic medication was administered during the encounter.

The measure includes instances of administration of hypoglycemic medications in the emergency department or in observation status at the start of an inpatient hospitalization when assessing inclusion of encounters in the measure denominator.

Denominator

Equals Initial Population

Equals Initial Population

Denominator Exclusions None None
Numerator

Inpatient hospitalizations where a severe hypoglycemic event occurred during the encounter, which is:

1. A blood glucose result less than 40 mg/dL

AND

2. A hypoglycemic medication administered within 24 hours prior to the start of the severe hypoglycemic event (i.e., the glucose result less than 40 mg/dL)

AND

3. No subsequent repeat test for blood glucose with a result greater than 80 mg/dL within five minutes of the start of the initial blood glucose test with result less than 40mg/dL

Only the first qualifying severe hypoglycemic event is counted in the numerator, and only one severe hypoglycemic event is counted per encounter. The 24-hour and 5-minute timeframes are based on the time the blood glucose was drawn, as this reflects the time the patient was experiencing that specific blood glucose level

Inpatient hospitalizations where a severe hypoglycemic event occurred during the encounter, which is:

- A glucose result less than 40 mg/dL

AND

- A hypoglycemic medication administered within 24 hours prior to the start of the severe hypoglycemic event (i.e., the glucose result less than 40 mg/dL)

AND

- No subsequent repeat test for glucose with a result greater than 80 mg/dL within five minutes of the time of the initial glucose test with result less than 40mg/dL

Only one qualifying severe hypoglycemic event is counted in the numerator, and only one severe hypoglycemic event is counted per encounter.

The 24-hour and 5-minute timeframes are based on the time the glucose was drawn, as this reflects the time the patient was experiencing that specific glucose level.

Numerator Exclusions

Not Applicable

Not Applicable

Denominator Exceptions

None

None

Measure Steward Centers for Medicare & Medicaid Services (CMS) Centers for Medicare & Medicaid Services (CMS)
Measure Scoring Proportion measure Proportion measure
Measure Type Outcome measure Outcome measure
Improvement Notation

A lower proportion indicates better quality

A lower proportion indicates better quality

Guidance

Note the measure is currently confined to using mg/dL as the unit of measurement for glucose results.

To calculate the hospital-level measure result, divide the total numerator events by the total number of qualifying inpatient hospitalizations (denominator).

Only the first qualifying severe hypoglycemic event is counted in the numerator, and only one severe hypoglycemic event is counted per encounter.

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Note the measure is currently confined to using mg/dL as the unit of measurement for glucose results.

Glucose levels are determined by laboratory or point-of-care (POC) tests, including capillary/glucometer blood glucose tests, and by interstitial fluid specimens from continuous glucose monitors. Glucose test results from urine specimens are not considered.

To calculate the hospital-level measure result, divide the total numerator events by the total number of qualifying inpatient hospitalizations (denominator).

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Next Version No Version Available
Previous Version No Version Available

Header

  • Updated grammar, wording, and/or formatting to improve readability and consistency.

    Measure Section: Description

    Source of Change: Annual Update

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated the rationale to reflect recent evidence supporting the importance of the measure.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated the Clinical Recommendation Statement to reflect current evidence.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Removed duplicative statement from guidance.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Revised the Initial Population narrative to reflect the updated age anchor to 18 years and older at the start of the inpatient hospitalization to harmonize with other hospital measures.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Revised the numerator to clarify the qualifying severe hypoglycemic event is not constrained to the first event in order to be counted in the numerator.

    Measure Section: Numerator

    Source of Change: Measure Lead

  • Updated the definition to reflect glucose tests and relevant results are not limited to blood specimen or laboratory or point of care test.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Revised the age anchor to 18 years and older at the start of the inpatient hospitalization to harmonize with other hospital measures.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Revised the timing associated with Laboratory Test, Performed data elements to use Global.'EarliestOf'() for the test timing to decrease implementation burden due to variable use of timing attributes for select QDM data types.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Revised glucose testing logic to constrain the test to the qualifying encounter to meet measure intent.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Definitions

    Source of Change: Standards/Technical Update

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Glucose Lab Test Mass Per Volume (2.16.840.1.113762.1.4.1248.34): Added 2 LOINC codes (1547-9, 99504-3) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hypoglycemics Severe Hypoglycemia (2.16.840.1.113762.1.4.1196.393): Added 1 RxNorm code (2589008) based on review by technical experts, SMEs, and/or public feedback. Deleted 28 RxNorm codes based on terminology update.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 5 SOP codes (1111, 1112, 142, 344, 141) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Jan 22, 2024