Table 1:
Description of ED Quality Measures
| Quality Measures | Numerator | Denominator |
|---|---|---|
| Acute Coronary Syndrome | ||
| Aspirin Given in ED | Aspirin given in ED OR Plavix given in ED if patient has allergy to Aspirin OR documentation of Aspirin or Plavix taken within 24 hours OR documented contraindication OR patient refusal | Patients in whom ED provider suspected ACS and ordered an ECG and troponin AND the patient had an abnormal troponin or ischemic ECG changes in ED OR patient was primarily admitted from ED for ACS, chest pain or rule-out ACS. |
| ST Elevation Myocardial Infarction | ||
| Time to PCI | PCI within 90 minutes of arrival to a STEMI receiving center OR PCI within 120 minutes of arrival to a STEMI referral center OR documented contraindication OR patient refusal | All ED patients with ST-elevation on ECG concerning for acute MI |
| Acute Ischemic Stroke | ||
| Time to Thrombolytics | tPA administered within 4.5 hours of symptom onset OR documented contraindication OR patient refusal | All ED patients with symptoms of an acute ischemic stroke |
| Inpatient Pneumonia | ||
| Guideline Concordant Parenteral Antibiotics | Parenteral antibiotics given in ED OR documented contraindication OR patient refusal | All ED patients with radiographic documentation of pneumonia on ED chest xray or CT OR ED treatment due to documented clinical suspicion for pneumonia* |
| Sepsis | ||
| 3 Hour Surviving Sepsis Bundle | Lactate measured AND Blood cultures obtained before antibiotics AND Antibiotics given AND 30mL/kg IV fluid given (if lactate > 4 or SBP < 90 or MAP < 65) within 3 hours of ED arrival | All ED patients with 2 SIRS criteria, suspected infection, and at least one marker of end organ dysfunction |
Abbrev: ED=emergency department; ACS=acute coronary syndrome; ECG=electrocardiogram;
PCI=percutaneous coronary intervention; MI=myocardial infarction; tPA=tissue plasminogen activator; CT=computerized tomography; SBP = systolic blood pressure; MAP = mean arterial pressure; SIRS=systemic inflammatory response syndrome
*
does not include antibiotics given for COPD exacerbation without pneumonia