Facilitating Cross-National Comparisons of Indicators for Patient ...

DELSA/ELSA/WD/HTP(2008)1Quick Step Overview of Essential Tasks for Data PreparationThe following outlines the key steps in preparing data for the calculation of the Patient Safety Indicators:1. Convert listed ICD codes to your country’s version of ICD2. Look up in your ICD classification if there are codes available for SIRS (Systemic InflammatoryResponse syndrome). If these codes are available add them to the numerator inclusion list of theindicator Postoperative Sepsis3. Look up in your ICD classification if there are codes available for Iatrogenic Pneumothorax. Ifthese codes are available add them to the numerator inclusion list of the indicator IatrogenicPneumothorax4. Look up the procedure codes in use in your country procedure classification for the followingprocedures:a. “Interruption of Vena Cava”Add a) to the denominator calculation of indicator Postoperative Pulmonary Embolism(PE) or Deep Vein Thrombosis (DVT).b. “Obstetric Trauma”Add b) to the numerator calculation of all Obstetric Trauma indicators.c. “Caesarean Delivery”Use c) to select the denominator population of indicator Obstetric Trauma –CaesareanSection Deliveries.d. “Instrument-Assisted Delivery procedure codes”Use d) to select the denominator population of indicator Obstetric Trauma - VaginalDelivery with Instrumente. “Hip fracture repair”Cases with e) are excluded from the denominator population of indicator PostoperativeHip Fracture if the hip fracture repair occurs before or on the same day as the firstoperating room procedure.f. “Endotracheal (re-)intubationCases with f) are in the numerator population of indicator Postoperative RespiratoryFailure if the reintubation occurs after the main OR procedureg. “Diaphragmatic surgery repair, thoracic and cardiac surgery, lung or pleural biopsy” (page.22, Annex 1 - Code List P)Add g) to the denominator exclusion of indicator Iatrogenic Pneumothorax5. Check the definition of principal diagnosis (PDx) applied in your country6. If the PDx definition is “the condition to be chiefly responsible” proceed to step 7. If the PDxdefinition is “the condition demanding the most resources”, rearrange the data as shown in theflowchart at Figure 1: PDx Algorithm.7. Flag cases with OR (operating room) procedures designated as “surgical”. A comprehensive list ofOR procedures must be provided by your country.8. Apply calculation algorithm to each case as shown in the indicator-related flowcharts.16