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

Last updated: June 9, 2017

CMS Measure ID: CMS32v6
Version: 6
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 during the measurement period

Measure Population:

Equals initial population

Measure Observations:

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

Measure Steward: Centers for Medicare & Medicaid Services (CMS)
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
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].facility location departure date and time minus [Encounter: encounter ED].facility location arrival date and time).

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.

Addendum Notes: ICD-10 Value Set addition

Specifications

Release Notes

Header

  • Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Measure Lead

  • Replaced emergency department visit attribute:(admission datetime) with (facility location arrival datetime) and (discharge datetime) to (facility location departure datetime) to use timestamps that reflect the arrival and departure date and times for the Emergency Department visit.

    Section: Guidance

    Source: JIRA (CQM-1645)

  • Modified the language for the description of the Initial Population to more accurately reflect the timing logic.

    Section: Initial Population

    Source: JIRA (CQM-1623)

  • Revised description to include same facility to clarify intent.

    Section: Measure Population Exclusion

    Source: JIRA (CQM-1499)

  • Revised Stratum 3 narrative to specifically state this includes patients who do not have a principal diagnosis consistent with mental disorders and who are not transferred.

    Section: Stratification

    Source: QDM Standards

Logic

  • Replaced operator 'Datetime difference of' with 'Datetimediff' to align with the name of the QDM function.

    Section: Measure Observations

    Source: QDM Standards

  • Removed Emergency Department visit <=6 hour(s) before or concurrent with the start of Inpatient Encounter from Measure Population logic to better align with the measure intent.

    Section: Measure Population

    Source: None

  • Added logic to exclude patients with an Emergency Department visit <=1 hour(s) before or concurrent with the start of the Inpatient Encounter in order to meet the intent of the measure.

    Section: Measure Population Exclusions

    Source: None

  • Added new attribute 'principal diagnosis' to 'Encounter, performed' datatype to conform to QDM 4.2 changes and provide more accurate logic. Removed QDM data element Attribute: 'Ordinality: Principal' using 'Principal SNOMEDCT Value Set (2.16.840.1.113883.3.1.7.1.14.)’ to conform to QDM 4.2. changes and provide more accurate logic.

    Section: QDM Data Elements

    Source: QDM Standards

  • Added 'Occurrence A of' to the Emergency Department Encounter and replaced the AND NOT Union of with AND NOT starting each line of logic.

    Section: Stratification

    Source: QDM Standards

  • Replaced 'Diagnosis, Active: XXX (ordinality: Principal)' datatype with 'Encounter, Performed: XXX (principal diagnosis: XXX)' datatype to conform with QDM 4.2 changes and provide more accurate logic.

    Section: Stratification

    Source: QDM Standards

Value Set

  • Value set Psychiatric/Mental Health Patient (2.16.840.1.113883.3.117.1.7.1.299): Deleted 477 ICD9CM codes. Added 15 SNOMEDCT codes and deleted 1 SNOMEDCT code (426041005). Added 121 ICD10CM codes and deleted 23 ICD10CM codes.

    Section: None

    Source: None

  • Value set Psychiatric/Mental Health Patient (2.16.840.1.113883.3.117.1.7.1.299): Added 13 ICD10CM codes and deleted 4 ICD10CM codes (F32.8, F34.8, F42, F50.8).

    Section: None

    Source: ICD-10 Addendum

External Resources