Median Time from ED Arrival to ED Departure for Discharged ED Patients

Last updated: July 12, 2017

CMS Measure ID: CMS32v5
Version: 5
NQF Number: 0496
Measure Description:

Median elapsed time from emergency department arrival to emergency room departure for patients discharged from the emergency department.

Initial Patient Population:

Emergency department encounters discharged during the measurement period.

Measure Population:

Emergency department encounters discharged during the measurement period.

Measure Observations:

Median elapsed time (in minutes) from emergency department arrival to emergency room departure for patients discharged from the emergency department.

Denominator Statement:

Not applicable

Denominator Exclusions:

Not applicable

Numerator Statement:

Not applicable

Numerator Exclusions:

Not applicable

Denominator Exceptions:

Not applicable

Measure Steward: Centers for Medicare & Medicaid Services
Domain: Communication and Care Coordination
Short Name: ED3
Next Version: Median Time from ED Arrival to ED Departure for Discharged ED Patients
Previous Version: Median Time from ED Arrival to ED Departure for Discharged ED Patients
Measure Score: Continuous Variable
Improvement Notation:

Improvement noted as a decrease in the median value

Guidance:

This measure uses a continuous variable. The specification provides elements from the clinical electronic record required to calculate for each ED encounter, i.e., the length of time the patient was in the Emergency Department, also stated as: the Emergency Department departure time minus the Emergency Department arrival time. The calculation requires the median of all ED encounter durations. This measure specification defines how to determine an individual Emergency Department stay. Reporting requires the median of all patient stays ([Encounter: encounter ED].departuredatetime - [Encounter: encounter ED].arrivaldatetime).

For each population, results should be reported without stratification and then with each stratum applied. For this measure, the number of encounters that fall into the Initial Population are reported without stratification, then reported according to the defined stratification. The number of encounters that fall into the Measure Population are reported without stratification, then reported according to the defined stratification. The computed continuous variable defined by the Measure Observation is reported for the Measure Population also, then reported according to the defined stratification.

The measurement period is one calendar year but the reporting period is 3 months as a calendar quarter; Q1 = Jan - Mar, Q2 = Apr - Jun, Q3 = Jul - Sep, Q4 is Oct - Dec.

Specifications

Release Notes

Header

  • A description for the rate aggregation was added to explain that the length of time the patient was in the Emergency Department, also stated as: the Datetime difference between the Emergency Department facility location departure time and the Emergency Department facility location arrival time. The calculation requires the median across all ED encounter durations.
  • Clarified that the Initial Population includes Emergency Department encounters discharged during the measurement period.
  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Measure Population description was refined to more accurately reflect the logic of the measure.
  • Modified description to align with measure logic.
  • Reporting stratum modified to include the use of principal diagnoses. Workflow practices regarding the assignment of principal diagnoses may affect the function of this measure.
  • Stratification 1 in the prior version of the measure was removed because it was redundant with the measure population. Strata have been renumbered to reflect this update.

Logic

  • Added Measure Population Exclusion to address the Patient Expired logic and to establish consistency across the stratum for ED quality measures.
  • ED encounter admission and discharge timestamps are used instead of facility location (ED) departure time for timing comparison logic.
  • Replaced DateDiff or TimeDiff functions with Datetime difference in the measure observation section, and removed 'AND' operators from the statements underneath the DateTimeDiff function.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Timing operator 'ends before start of' replaced with 'ends before or concurrent with start of' in criteria relating Emergency Department Visit with Inpatient Encounter.This allows for cases in which the ED discharge and inpatient admission occur in the same minute to evaluate to true.

Value Sets

  • Psychiatric/Mental Health Patient Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.299): Deleted 21 SNOMED codes and 52 ICD10CM codes, and added 75 SNOMED codes.
  • Value set Acute care hospital (OID 2.16.840.1.113883.3.666.5.684): Updated value set name form Hospital Measures-Acute care hospital to Acute care hospital and deleted 15 SNOMED codes and add 1 SNOMED code.
  • Value set Patient Expired (OID 2.16.840.1.113883.3.117.1.7.1.309): Replaced value set Expired (OID 2.16.840.1.113883.3.666.5.730).

External Resources