2014 Changes for Core Measures that Impact Physicians
Guideline for Documenting Overlap Therapy for treatment of VTE:
- Overlap therapy: Patients must receive five days of parenteral and warfarin therapy
- If patient does NOT receive five days of overlap therapy, then additional documentation is required:
- Must be physician, APN, PA or pharmacist documentation
- Must be documented on day overlap therapy is discontinued
- Must link why parenteral therapy was discontinued
Guideline for Documenting SCIP-Inf-1, 2 and 3:
- Patients on home antibiotics must include a reason for continuing post-op
VTE-3: Patients receiving anticoagulation overlap therapy for the treatment of VTE:
- This measure assesses the number of patients diagnosed with confirmed DVT/PE who received an overlap of parenteral anticoagulation
and warfarin therapy. For patients who received less than five days of overlap therapy, they should be discharged on both medications
or have a Reason for Discontinuation of Parenteral Therapy.
- If overlap therapy is discontinued, there must be physician, APN, PA or pharmacist linking documentation of why the parenteral
therapy was discontinued.
- What’s new: This documentation must be found on the same day that parenteral therapy was discontinued. (Example:
Lovenox discontinued on 2/1/14. The reason for discontinuing the lovenox must be documented on 2/1/14. (i.e: INR 2.6, will discontinue
- Key Point: The reason for discontinuing parenteral therapy must be written on the same
day that the parenteral therapy is discontinued. Addendums will no longer be accepted for this measure.
SCIP-Inf-1, 2 and 3:
- These measures assess antibiotic administration within 1 hour prior to incision time, antibiotic selection and antibiotic
discontinuation within 24 hours of anesthesia end time (48 hours for CABG/other cardiac surgery).
- What’s new: Patients on home/chronic antibiotics prior to arrival are no longer excluded from these measures.
Therefore, if a home antibiotic is continued beyond 24 hours after anesthesia end time (48 hours for CABG/other cardiac surgery),
there must be a reason documented for continuing the antibiotic. (example: infection, possible/suspected infection.
New: treatment of acne or rosacea are now included.)
- Key Point: All surgery patients with antibiotics continuing beyond 24 hours after anesthesia end time (48 hours
for CABG/other cardiac surgery) must have documentation by the physician/APN/PA to support the need. This even applies
to patients with home/chronic antibiotics.
<<Back to the March 2014 issue of Premier Pulse