Summary of Acute Myocardial Infarction (AMI) - QualityNet

FACT SHEET
Summary of Acute Myocardial Infarction (AMI) Measure Changes for
1/1/2012 + Discharges
AMI and Chest Pain are now separate measure sets.
There is a new measure OP-16: Troponin Results for Emergency Department acute myocardial
infarction (AMI) patients or chest pain patients (with Probable Cardiac Chest Pain) Received
within 60 minutes of arrival.
The information below consists of clarifications and changes in abstraction instructions.
Data Element or Table: Data Dictionary
• Three data elements were retired (Discharge Date and Time, ECG Date and Time and
Fibrinolytic Administration Date and Time).
• Nine data elements were added (ECG Date, ECG Time, ED Departure Date, ED Departure
Time, Fibrinolytic Administration Date, Fibrinolytic Administration Time, Troponin Order,
Troponin Result Date, Troponin Result Time).
Arrival Time – The Notes for Abstraction were changed to clarify abstractor guidance.
• Arrival Time should be abstracted at face value from the ONLY ACCEPTABLE SOURCES.
The ONLY ACCEPTABLE SOURCES are expanded to include nursing admission
assessment and admission notes, observation record, procedure notes or the VS graphic
record.
• Addressographs/stamp time are exclusions.
• Directions for arrival time for patients with observation status and patients that are direct
admits are addressed separately.
• Examples were added for clarification.
Initial ECG Interpretation – Notes for Abstraction were changed for further abstraction
clarification.
• Documentation must clearly identify the inclusion terms as ECG findings that are new or
significant.
• Documentation of ST elevation with a range that is less than 1 mm/.10mV should be
disregarded.
Probable Cardiac Chest Pain
• Trauma and MVA (Motor Vehicle Accident) were added as exclusions.
• Chest X-Ray Reports, Radiology Reports are excluded data sources.
Reason for Delay in Fibrinolytic Therapy – Significant updates were added to align with HIQR
element.
Reason for No Aspirin on Arrival
Add Pradaxa/dabigatran etexilate as an acceptable pre-arrival medication for value 2.
Reason for Not Administering Fibrinolytic Therapy – Changed exclusion for ‘Poorly
controlled hypertension’ to be defined as ‘Severe uncontrolled hypertension on presentation
(SBP > 180 mm Hg or DBP > 110 mm HG).’
Summary of 1/1/12 Outpatient AMI Manual Revisions Page 1 of 2
Updated: January 2012

For a complete list of changes, please see the “Release Notes” located in the Specifications
Manual for Hospital Outpatient Department Quality Measures for encounters 1/1/2012. The
manual can be found at:
http://qualitynet.org/dcs/ContentServerc=Page&pagename=QnetPublic%2FPage%2FQnetTier
2&cid=1196289981244
This material was prepared by the Hospital Outpatient Measures Team by Oklahoma
Foundation for Medical Quality Inc., the Medicare Quality Improvement Organization for
Oklahoma, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency
of the U.S. Department of Health and Human Services. The contents presented do not
necessarily reflect CMS policy. 4-1374-OK-1211
Summary of 1/1/12 Outpatient AMI Manual Revisions Page 2 of 2
Updated: January 2012