CAPC Palliative Care Discussion Forum
Data Collection and Measurement
I'm trying to adopt the consensus metrics published for palliative care consult services (Weissman, Meier, Spragens in JPM 2008)
"To accurately capture the depth of palliative care service integration, the total number of hospital admissions used as the denominator should exclude admissions from: obstetrics (except for pediatric palliative care programs), psychiatry, ophthalmology, inpatient rehabilitation, and short-stay observation unit admissions."
Our hospital uses 'discharges' rather than 'admissions' to determine volume etc...
a few questions:
1. what about pediatric admissions or discharges? i know this seems obvious but If i want to compare to benchmarks this report suggest you count pediatric admission whether or not you have a pediatric program.
2. would it be reasonable to account for consults as # of new consults (by initial consult date)/ 100 discharges. Or should I look at # of new consult (by discharge date)/ 100 discharges.
3. If I use discharges there is also the category of 'newborns' I would assume I need to exclude these as we have an adult program. What impact will this have if we are trying to create national benchmarks (perhaps I should include the newborn #s as this is not defined as an excluded classs in the metric)?
4. Should I push for admission numbers knowing that the rest of the hospital bases their reporting on discharge numbers? (i'd prefer not to creat two numbers which will be close in number).
i'm trying to balance my specific program needs within the context of our palliative care community. thoughts.
adam
IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must
login. If you are not a registered member you may
join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.
General questions about using the
CAPCconnect™ palliative care discussion forum?
Email:
Jennifer.Raiten@mssm.edu
Lost login username/password questions? Email:
Margaret.Schutz@mssm.edu
Consults/100 admissions metric
1. what about pediatric admissions or discharges? i know this seems obvious but If i want to compare to benchmarks this report suggest you count pediatric admission whether or not you have a pediatric program.
Answer: only count peds if your program sees pediatric patients as a routine part of your program; if you only see a rare pediatric patient for some special reason, do not include peds patients in the denominator.
2. would it be reasonable to account for consults as # of new consults (by initial consult date)/ 100 discharges. Or should I look at # of new consult (by discharge date)/ 100 discharges.
Answer: I don't see a difference between these two options-what difference does the date of consult make as long as its within the hospitalization period?
3. If I use discharges there is also the category of 'newborns' I would assume I need to exclude these as we have an adult program. What impact will this have if we are trying to create national benchmarks (perhaps I should include the newborn #s as this is not defined as an excluded classs in the metric)?
Answer: see #1--do not count newborns if your PC program does not routinely see this population.
4. Should I push for admission numbers knowing that the rest of the hospital bases their reporting on discharge numbers? (i'd prefer not to creat two numbers which will be close in number).
Answer: use data that is most aligned with the rest of your hospital. However, for submission to the CAPC National Registry, the question asks about Admissions rather than Discharges.
David Weissman, MD
CAPC Consultant