Patient safety indicators introduction this documentation describes the software for implementing the patient safety indicator psi module of the ahrq quality indicators version 2. The ahrq ccs diagnosis and procedure crosswalks show the assignment of icd9icd10 codes to the ccs diagnosis and procedure categories. The comorbidity software consists of three sas computer programs for pcs. Tables summarizing revisions made to the psi software, software documentation and technical specifications since the original release of these documents in. To examine criterion validity, we selected 1217 psis. The first program, creation of format library for elixhauser comorbidity groups, creates a sas format library that maps. Success in hospitalacquired pressure ulcer prevention. Validity of selected ahrq patient safety indicators based on.
Sas program, which contains code the user must modify in order to run the psi. Ahrq wants to hear from you to help improve the qi program. Topics approach to improving safety patient safety indicators benchmarking clinical information ahrq prevention quality indicators use hospital admissions data to screen for potential quality lapses indicators. We identified psi flagged cases from 28 representative hospitals by applying the ahrq psi software v. The consumer assessment of healthcare providers and systems cahps program is a multiyear initiative of the agency for healthcare research and quality ahrq to develop surveys of patients experiences with the healthcare they receive from health plans, providers, and facilities such as hospitals, incenter hemodialysis facilities, and home.
Objective to assess whether use of the ahrq patient safety indicator psi composite measure versus modified composite measures leads to changes in hospital profiles and payments. The software allows organizations to apply the ahrq quality indicators qis to their own data. Quality indicators software instructions, sas qi v2019 icd10cmpcs. Sas input and output files for the psi software package. Ahrq provides a software program that applies standardized algorithms to hospital administrative data, specifically utilizing icd codes and extensive exclusion criteria, described further in the methods section.
The agency for healthcare research and quality ahrq quality indicators qis program. The ahrq academy web portal video provides an overview of the all. For more information please see the following links on the microsoft website. We identified psiflagged cases from 28 representative hospitals by applying the ahrq psi software v. Business health care industry medical errors prevention patient care laws, regulations and rules patients care and treatment safety and security measures. For details on what is fixed in this release, please see the release note. For more information on composite workgroups, visit the ahrq qi composite workgroups page. This allows the analyst or analyzing team to identify the exact issue, identify the reason for the problem s occurrence, and to develop means to prevent the issue from recurring or. The cms patient safety and adverse events composite cms psi 90 is a subset of the ahrq patient safety indicators and is a more relevant measure for the medicare population because it utilizes icd10. The agency for healthcare research and quality ahrq, in conjunction with the johns hopkins medicine armstrong institute for patient safety and quality and norc at the university of chicago, created the ahrq safety program for. Sas is a statistical software package distributed by the sas.
Verbal protocol analysis ahrq digital healthcare research. The pqis measure preventable hospitalizations for ambulatory care. Ahrq has received many questions regarding the implementation of the patient safety rule and about psos. Validity of selected ahrq patient safety indicators based on va national surgical quality improvement program data. Psi 14 postoperative wound dehiscence rate psi 15 accidental puncture or laceration rate the ahrq psi 90 composite is a weighted average of the risk and reliabilityadjusted versions or smoothed versions of these eight psis. The ahrq academy offers numerous products to help integrate behavioral health and primary care. This report summarizes the work of the psi composite measure workgroup, which assisted ahrq in developing a composite measure based on the patient safety indicators. Death rate among surgical inpatients with serious treatable conditions. Additionally, on october 1, 2014 fiscal year 2015, cms began using ahrqs patient safety for selected indicators psi90 as a core metric in 2 of its payforperformance programs. Uneven capture of these data has the potential of affecting rates and should be kept in mind when judging the level of these events. What barriers did cms have to consider with the icd 10 cmpcs implementation. Ahrq created the common formats common definitions and reporting formats to help uniformly report patient safety events and to improve health care providers efforts to minimize and potentially eliminate harm. Ahrq has developed sas programs and free qi software for windows that you can use to calculate your qi rates. Although these programs are written in sas, they are being distributed in ascii so that they can be readily adapted to other programming languages.
In the interim, we have temporarily removed, these qi population files and the winqi software program the prevention quality indicators pqis, although a few arealevel indicators are embedded in the other hospital settings. Overview of the ahrq qis, data requirements, and issues involved in using them. Ideal for advanced users to run in a sasstat software package. Psi rates at the university of michigan health system umhs and inform users about the potential problems in using psis for patient safety performance and public reporting. February 2020 3m quality webinar presented by cheryl manchenton. Ahrq psi composite measure patient safety for selected.
This psi is also publicly reported by cms and an average national rate of. Sas load programs are provided by state, by year, by database type. The fy 2018 hac reduction program used recalibrated version 6. For the fy 2016 program, cms calculated smoothed versions of these eight psis using version 4. Do the ahrq patient safety indicators flag conditions that. Software results of comparison testing between sas and winqi software. The agency for healthcare research and quality ahrq s programs offer practical information to help a variety of health care organizations, providers, and others make care safer in all. The psis can be used to help hospitals assess the incidence of adverse events and inhospital complications and identify issues that might need further study. Common formats ahrq patient safety organization program. This allows the analyst or analyzing team to identify the exact issue, identify the reason for the problem s occurrence, and to develop means to prevent the issue from recurring or reduce the probability that it will happen again. Fiscal year 2020 hospitalacquired conditions reduction. Frequently asked questions ahrq patient safety organization.
Overview psos are required to collect and analyze data in a standardized manner. By cheryl manchenton, rn, bsn, ccds if you search for patient safety indicator psi 90 patient safety and adverse events composite in the agency for healthcare research and qualitys ahrq version 7. Tailoring an educational program on the ahrq patient. Iqi, psi, and pdi rates generated by the ahrq sas programs. A verbal protocol analysis vpa is a thinkaloud method of eliciting cognitive and physical process descriptions from a user. Patientlevel administrative data abstracted from individual patient records and facilitylevel utilization data on healthcare services from hospitals and healthcare facilities. Updates on patient safety indicators psis for use in cms. Pdf the link between clinically validated patient safety. Dec 10, 2015 the ahrq psi 90 composite is a weighted average of the risk and reliabilityadjusted versions or smoothed versions of these eight psis. Next, we developed and implemented a program based on the formative evaluation. Toolkit for using the ahrq quality indicators agency for. Ppt validating ahrq patient safety indicators with.
Root cause analysis ahrq digital healthcare research. Patient safety indicator12 rarely identifies problems. The ahrq quality indicators windows application may be installed on 64bit or 32bit platforms, and no thirdparty statistical software is needed. A zip file containing the sas load programs for current andor previous versions of databases and years is also provided. Ahrq qi software putting the power of ahrq quality indicators in your hands. To use these modules, users must have access to sas, which may be purchased from the sas institute. Patient safety, agency for health care research and quality, report by health services research. Psi 15 unrecognized abdominopelvic accidental puncturelaceration rate the cms v9. Elixhauser comorbidity software assigns variables that identify comorbidities in hospital discharge records using the diagnosis coding of icd9cm international classification of diseases, ninth edition, clinical modifications. We conducted an implementation and evaluation study from 2011 to 20. The load programs are provided in sas format and there is one sas load program for each data file.
Ahrq quality indicators software instructions, windows. A comparison of ahrqpsi with acsnsqip data has been reported previously, but this comparison was based on 2001 data from the veterans health administration va from 2001. The cohort for the hospitalwide readmission measure is defined using the clinically meaningful ahrq ccs diagnosis and procedure categories. The psi 90 measure is a claimsbased measure that has been calculated using 24 months of data. The ahrq qi program is unique in that it provides free, publicly. Reports based on healthcare utilization data to support higher quality, more efficient, and costeffective patient care. Fiscal year fy 2016 results for the cms hospitalacquired. While the ahrq qi software v2018 icd10 cmpcs is intended for an all payer population and nonrisk adjusted.
The ahrq safety program for improving antibiotic use. In response to these questions, and in anticipation of additional inquiries, below is a list of frequently asked questions and corresponding answers. Patient safety indicators software instruction, sas ahrq quality. The goal of a root cause analysis is to identify a problem s origin by following a series of steps. A free powerpoint ppt presentation displayed as a flash slide show on id. Software for calculating the failure to rescue psi version 5 for icd9 and version 6 for icd10 is publicly available psi 04. This output was generated in march 2016 using an alpha version of the ahrq sas qi software v6. For the fy 2018 and fy 2019 payment determinations, measure rates. Application files now organized into separate folders for user program, macros, and parameter files. Clinical and coding input was used to modify ahrqs psi definitions. Ahrq quality indicators, spss software documentation, version 2.
The toolkit for using the ahrq quality indicators qi toolkit is a free and easytouse resource for hospitals planning to use the ahrq quality indicators qis, including the patient safety indicators psis, to track and improve inpatient quality and patient safety. The ahrq psi 90 composite is a weighted average of the risk and reliabilityadjusted versions or smoothed versions of these eight psis. The sas version of the psi software is designed as a. Tailoring an educational program on the ahrq patient safety. Frequently asked questions and definition of terms used in the patient safety act or rule are summarized here solely for convenience. Discover the latest literature, news, and expert commentary on patient safety topics. For example, the component weight for psi 15 unrecognized abdominopelvic accidental puncturelaceration rate decreased by 98. Users can find more general documentation on the qi development process using allpayer data under the modulesgeneral tab, and psi specific documentation under the modules psi resources tab, on the ahrq qi website opens in new browser tab. The programs documented here were developed for use in statistical analysis system. To learn about stakeholders perceptions of the program, a postprogram evaluation survey was administered approximately 1 month after the psi education program ended. Comorbidity measures for use with administrative data.
Ahrq quality indicators qis and how to use those rates to assess the hospitals performance on the indicators. The qi toolkit also may serve as a general guide to applying improvement methods in a hospital setting. Users can find more general documentation on the qi development process using allpayer data under the modulesgeneral tab, and psispecific documentation under the modulespsi resources tab, on the ahrq qi website opens in new browser tab. Use of this free software ensures a standard, trusted approach to quality measurement and means more resources are available for supporting improvements to patient care. Use of this free software ensures a standard, trusted approach to quality measurement and.
For the fy 2017 program, cms calculated the score using recalibrated version 5. In v2019, the patient safety indicators psi module contains one. The descriptions are of processes that are performed by the user to complete a specific task. During the webinar cheryl will discuss the impact of changes introduced with ahrq psi v2019. July 2019 hospital compare public reporting and fy 2020 hac reduction program used cms v9. The qistat modules are programs that run in the sas statistical software package. Methods software from ahrq for the patient safety indicators, version 3. Quality measures fact sheet center for medicare and. Ahrq quality indicators, qi, use hospital inpatient administrative data to measure health care quality, identify areas for further study, and track changes over. Ahrq projects funded by the patientcentered outcomes research trust fund. The national integration academy council niac and project team members developed these products to provide definitions, measures, exemplars, strategies, lessons learned, and other practical wisdom for application in the field.
This document describes the software that creates the comorbidity measures reported by elixhauser et al. The were developed for the ahrq, which is a federal agency in the department of health and human services. Using harmbased weights for the ahrq patient safety for. Ahrq quality indicators, qi, use hospital inpatient administrative data to measure. This survey, consisting of 90 closedended questions and 12 openended questions, was administered to those va stakeholders who had both 1 responded to the preprogram survey. For more information about the prevention quality indicators, download the patient safety indicators brochure. Validity of selected ahrq patient safety indicators based. E codes in the ahrq psi and pdi software have been augmented wherever possible with the related none codes in the icd9cm system, e codes are still included in some ahrq psi and pdi definitions.
The component weight for psi 14 postoperative wound dehiscence rate decreased by 51. Pdf agency for healthcare research and quality ahrq. An example of the output from the sas programs for the psi rates is provided on the following pages. We began with a formative evaluation involving telephone interviews and webbased surveys with stakeholders, which allowed us to learn more about their psi educational needs and how the program should be tailored. Out of the 112 cases flagged by the ahrq psi software, only 48 were true events of postoperative dvt.
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