Patient Safety Indicators With Diagnosis Present on Admission (POA) 2016
Center for Health Statistics
Texas Health Care Information Collection
The Patient Safety Indicators (PSIs) are a set of indicators providing information on potential in hospital complications and adverse events following surgeries, procedures, and childbirth. The PSIs were developed by 3M™, after a comprehensive literature review, analysis of ICD-10-CM codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses. The PSIs below include Diagnosis Present on Admission (POA) included in calculations, POA exempt hospitals are excluded.
The PSIs can be used to: help hospitals identify potential adverse events that might need further study; provide the opportunity to assess the incidence of adverse events and in hospital complications using administrative data found in the typical discharge record; include indicators for complications occurring in hospital that may represent patient safety events; and, indicators also have area level analogs designed to detect patient safety events on a regional level.
Important Note: Starting 2015, a significant change in coding systems occurred. Federal requirements necessitated the change in coding systems, from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS). The change occurred on October 1, 2015. The change will make the data difficult to utilize and compare between 2016 data and between QI reports from previous years. 2016 measures are not risk-adjusted due to this being the first year of data using the ICD-10-CM/PCS codes.
In-hospital
deaths per 1,000 surgical discharges, among patients ages 18 through 89 years
or obstetric patients, with serious treatable complications (deep vein
thrombosis/ pulmonary embolism (clotting or blockage of blood vessels that
cause other complications), pneumonia (inflammation of the lungs caused
by bacteria, virus or irritating drug or substance), sepsis (inflammation
of many areas of the body generally due an infection by bacteria which may
cause death), shock/cardiac arrest (a condition where not enough oxygen
carrying blood can be delivered to the body tissues or organs and may lead to
death or destruction of the tissue) or gastrointestinal
hemorrhage/acute ulcer (a conditions where there is an injury or destruction
of normal tissue in the stomach and intestines). Includes metrics for the
number of discharges for each type of complication. Excludes cases transferred
to an acute care facility.
Iatrogenic Pneumothorax Rate (PSI 06)
Iatrogenic
pneumothorax (accidental puncture of the lungs by medical personnel or
devices) cases (secondary diagnosis) per 1,000 surgical and medical
discharges for patients ages 18 years and older. Excludes cases with chest
trauma, pleural effusion (fluid surrounding the lungs), thoracic surgery
(surgery involving the organs inside the chest are), lung or pleural
biopsy (a procedure to remove a piece of the lung or the outer covering of
the lung for further examination and testing), diaphragmatic surgery repair
(a procedure to repair the primary muscle for breathing) , or cardiac
procedures (heart procedures); cases with a principal diagnosis of
iatrogenic pneumothorax; cases with a secondary diagnosis of iatrogenic
pneumothorax present on admission; and obstetric cases.
Perioperative
hemorrhage (bleeding from tissues around the surgical site) or hematoma
(a condition where the tissue swells up with blood making a nodule in the
tissue) cases with control of perioperative hemorrhage, drainage of
hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure
following surgery per 1,000 surgical discharges for patients ages 18 years and
older. Excludes cases with a diagnosis of coagulation disorder (a condition
that affects the clotting of tissue); cases with a principal diagnosis of
perioperative hemorrhage or hematoma; cases with a secondary diagnosis of
perioperative hemorrhage or hematoma present on admission; cases where the only
operating room procedure is control of perioperative hemorrhage, drainage of
hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure; and
obstetric cases.
Postoperative
respiratory failure (secondary diagnosis) (when the patient stops breathing),
mechanical ventilation (a procedure of using a device to assist the patient
in breathing), or reintubation (a procedure to put another tube into the
air passage way) cases per 1,000 elective surgical discharges for patients
ages 18 years and older. Excludes cases with principal diagnosis for acute
respiratory failure; cases with secondary diagnosis for acute respiratory
failure present on admission; cases in which tracheostomy (a procedure to
create a hole in the air way in the lower part of the throat to insert a tube
for breathing or administering other medications) is the only operating
room procedure or in which tracheostomy occurs before the first operating room
procedure; cases with neuromuscular disorders (problems with nerves and/or
muscles), laryngeal (the tissue that allows you to speak) or
pharyngeal (the soft tissue at the back of the mouth and nose) surgery,
craniofacial anomalies (birth defects of the head and face) that had a
procedure for the face, esophageal resection (a procedure to remove part of
the tissue where food travels down from the mouth to the stomach), lung
cancer, or degenerative neurological disorders (conditions where the nerves
are becoming less effective); cases with a procedure on the nose, mouth, or
pharynx; cases with respiratory or circulatory diseases (conditions
involving the heart and blood vessels); and obstetric discharges (female
patients which are being treated or examined for condition involving their
reproductive organs).
Postoperative
sepsis cases (secondary diagnosis) (patients which develop inflammation over
many parts of the body from an infection after a surgery) per 1,000
elective surgical discharges for patients ages 18 years and older. Excludes
cases with a principal diagnosis of sepsis, cases with a secondary diagnosis of
sepsis present on admission, cases with a principal diagnosis of infection,
cases with a secondary diagnosis of infection present on admission (only if
they also have a secondary diagnosis of sepsis), cases with an
immunocompromised state (a condition where the body’s defense mechanism are
decreased due to a non-normal bacteria, virus or other substances comes in
contact with the body), cases with cancer, obstetric discharges (female
patients which are being treated or examined for condition involving their
reproductive organs), and cases with stays less than four (4) days.
Accidental
punctures (when some foreign substance actually goes into a tissue of the
body) or lacerations (when tissue is torn by some forceful event, NOT a
cut from a sharp object) (secondary diagnosis) during procedure per 1,000
discharges for patients ages 18 years and older. Excludes cases with accidental
puncture or laceration as a principal diagnosis, cases with accidental puncture
or laceration as a secondary diagnosis that is present on admission, spinal
surgery cases, and obstetric cases.
Detailed Technical Specification for each Patient Safety Indicator and other methodology/calculation information can be found from AHRQ website link: http://qualityindicators.ahrq.gov/Modules/psi_resources.aspx
Previous Years Data
Patient Safety Indicators With Diagnosis Present on Admission (POA) 2014
Indicators of Inpatient Care in Texas Hospitals, 2012
Hospital Comments, 2012
Hospital Characteristics, 2012 (Excel)
Indicators of Inpatient Care in Texas Hospitals, 2011
Hospital Comments, 2011
Hospital Characteristics, 2011 (Excel)
Indicators of Inpatient Care in Texas Hospitals, 2010
Hospital Comments, 2010
Hospital Characteristics, 2010 (Excel)
Indicators of Inpatient Care in Texas Hospitals, 2009
Hospital Comments, 2009
Hospital Characteristics, 2009 (Excel)
Texas Health Data
Texas Health Data
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