The Patient Safety Indicators (PSIs) are a set of 26 indicators (including 18 provider-level indicators) developed by the Agency for Healthcare Research and Quality (AHRQ) to provide information on safety-related adverse events occurring in hospitals following operations, procedures, and childbirth. The PSIs were developed after a comprehensive literature review, analysis of available ICD-9-CM1 codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses.
Full Answer
How are patient safety indicators used?
How are Patient Safety Indicators used? The PSIs can be used to help hospitals assess the incidence of adverse events and in-hospital complications and identify issues that might need further study. For more information about the Prevention Quality Indicators, download the Patient Safety Indicators Brochure .
What are the prevention quality indicators (PSIS)?
The PSIs can be used to help hospitals assess the incidence of adverse events and in-hospital complications and identify issues that might need further study. For more information about the Prevention Quality Indicators, download the Patient Safety Indicators Brochure .
What are the AHRQ Quality Indicators?
The Agency for Healthcare Research and Quality (AHRQ) developed Quality Indicators for that purpose. There are four categories of AHRQ Quality Indicators: Patient Safety, Prevention Quality, Inpatient Quality, and Pediatric Quality.
What is the psi 90 Composite Indicator?
The PSI 90 composite indicator is intended to be used primarily to monitor performance in national and regional reporting, and also for comparative reporting and quality improvement at the provider level. It is not intended to reflect any broader construct of quality, beyond what is reflected in the component indicators themselves.
What is patient safety indicator?
The Patient Safety Indicators (PSIs) are a set of 26 indicators (including 18 provider-level indicators) developed by the Agency for Healthcare Research and Quality (AHRQ) to provide information on safety-related adverse events occurring in hospitals following operations, procedures, and childbirth.
What are examples of patient safety indicators?
Examples of this include the ability to link multiple hospital stays associated with one patient; the availability of bedsection data; more diagnosis and procedure codes; and admission, discharge, and procedure times.
What are the four quality indicators?
Quality Indicator Modules The AHRQ QIs include four modules: Prevention Quality Indicators (PQIs), Inpatient Quality Indicators (IQIs), Patient Safety Indicators (PSIs), and Pediatric Quality Indicators (PDIs).
What are the quality indicators in healthcare?
The Quality Indicators (QIs) are measures of health care quality that use readily available hospital inpatient administrative data. AHRQ develops Quality Indicators to provide health care decisionmakers with tools to assess their data.
What is quality indicators in nursing?
Quality Indicators (QIs) are standardized, evidence-based measures of health care quality that can be used with readily available hospital inpatient administrative data to measure and track clinical performance and outcomes.
What is a performance indicator in healthcare?
A healthcare Key Performance Indicator (KPI) or metric is a well-defined performance measure that is used to observe, analyze, optimize, and transform a healthcare process to increase satisfaction for both patients and healthcare providers alike.
What is quality indicator checklist?
A quality indicator checklist enables you to view National Quality Forum (NQF) inpatient quality measures independent of an InterQual® Level of Care review. ⓘ Note: Applies to InterQual Level of Care Acute Adult and Pediatric subsets. Follow these steps to view a quality indicator checklist.
What are key quality indicators?
KQI stands for key quality indicator. This metric measures the quality of excellence of a task or project. To find quality, you compare two or more items against each other that are similar to see which has the best results. You rarely measure quality with just one number, like some other metrics.
What types of indicators are used to assess quality?
Outcome, process and structure indicators Indicators can be described as three types—outcome, process or structure - as first proposed by Avedis Donabedian (1966). The national safety and quality indicators of safety and quality in health care recommended in this report include indicators of all three types.
What is the best indicator of healthcare quality?
5 Important Hospital Quality IndicatorsPQIs or Indicators for In-hospital Prevention Practices. PQIs are metrics that involve the use of hospital inpatient discharge data. ... IQIs or Indicators for Inpatient Quality of Care. ... Patient Safety Indicators. ... PQIs or Pediatric Quality Indicators. ... Rate of Readmissions.
What are Patient Safety Indicators?
The Patient Safety Indicators (PSIs) provide information on potentially avoidable safety events that represent opportunities for improvement in the delivery of care. More specifically, they focus on potential in-hospital complications and adverse events following surgeries, procedures, and childbirth.
Why are PSIs important?
The PSIs can be used to help hospitals assess the incidence of adverse events and in-hospital complications and identify issues that might need further study. For more information about the Prevention Quality Indicators, download the Patient Safety Indicators Brochure .
What is the ICD-9-CM?
The Patient Safety and Adverse Events Composite for the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) v6.0, 2016), is an updated and modified version of the Patient Safety Indicator for Selected Indicators Composite (v5.0 and prior).
Does QI software include PSIs?
Starting with V7.0 ICD-10-CM/PCS, all versions of the QI software will not include any area-level PSIs. For additional information, see the retirement announcement.
What is the CMS PSI 90?
The CMS Patient Safety and Adverse Events Composite (CMS PSI 90) is a subset of the AHRQ Patient Safety Indicators and is a more relevant measure for the Medicare population because it utilizes ICD-10 data. The CMS PSI 90 measure summarizes patient safety across multiple indicators, monitors performance over time, and facilitates comparative reporting and quality improvement at the hospital level. The CMS PSI 90 composite measure (updated on August 23, 2018) intends to reflect the safety climate of a hospital by providing a marker of patient safety during the delivery of care. The CMS Innovation Center is promoting this measure for BPCI Advanced because it may inform how patients select care options, providers allocate resources, and payers evaluate performance. CMS uses the CMS PSI 90 v.9.0 software to produce the CMS PSI 90 results. CMS has used or is currently using the CMS PSI
What is the PSI 90 measure?
The CMS PSI 90 measure selected for BPCI Advanced follows National Quality Forum (NQF) #0531 measure specifications. CMS calculates the measure at the hospital level and calculates a weighted average based on each of the following indicators:
When will the BPCI data be collected?
In Model Year 3, the claims data will be collected from January 1, 2019 to December 31, 2020.
Know Your PSIs
PSIs provide information on possible hospital complications and adverse events that may follow surgeries, procedures, and childbirth. They also help hospitals identify, assess, monitor, track, and improve the safety of inpatient care.
The Role of a PSI Auditor
As the Audit and Quality Monitoring Coordinator for the Health Information Services Department at the University of Missouri Health Care, I work with PSIs daily.
Quick Tips for Coding
As a coder, it is important to understand what code assignments might trigger a PSI and to be familiar with some basics of the more common PSIs that hit your healthcare organization. Here are some quick tips to keep in mind for three common PSI triggers: Tip No.
What is the patient safety indicator 15?
The Agency for Healthcare Research and Quality’s (AHRQ) patient safety indicator (PSI)-15 for accidental puncture or laceration is a quality measure that is intended to gauge and report a physician’s rate of inadvertent cuts, punctures, perforations, and lacerations during a surgical procedure. 1 The American College of Surgeons (ACS) sought clarification from the Centers for Medicare & Medicaid Services (CMS) regarding the correct reporting of PSI-15. At the crux of the ACS’ concerns is the lack of clarity as to what constitutes an “accident.” Punctures or lacerations that occur in surgical procedures often are incorrectly coded as “accidental” when the puncture or laceration was, in fact, a natural consequence or part of the operation.
What is 998.2 in medical billing?
When hospitals report 998.2 as an additional diagnosis, it counts as a complication or comorbidity (CC) or a major complication or comorbidity (MCC). The billing of CCs or MCCs often contributes to a higher diagnosis related group (DRG), resulting in increased reimbursement for the hospital. Given that hospitals could have an incentive to report 998.2 in order to increase reimbursement, it is important that hospital coders, who are primarily responsible for determining whether to report 998.2, understand how to use it correctly.
What is the ICd 9 coding clinic?
As noted in CMS’ response to the ACS’ concerns, the American Hospital Association (AHA) Coding Clinic for ICD-9-CM sought to clarify the issue regarding punctures and laceration in response to providers’ questions. The following questions and answers are taken from two AHA Coding Clinic publications. 4,5
What is the ICd 9 code for laceration?
The ACS also encourages surgeons to work with hospital staff to ensure proper coding. Using ICD-9-CM code 998.2 in situations where the puncture or laceration is expected and not accidental would be inappropriate use of the ICD-9-CM code and could negatively affect a hospital’s and surgeon’s quality reports. Appropriate use of ICD-9-CM code 998.2 will contribute to a more accurate picture of both the hospital’s and surgeon’s quality of care and also give the Medicare program and patients more useful quality measurement information.
What is the PSI-15?
PSI-15 is a measure that generates a ratio of reported events. The denominator includes most surgical and medical discharges, with a few exclusions. The numerator is intended to capture accidental cuts, punctures, perforations, or hemorrhages during medical care and is triggered when the hospital codes 998.2. Therefore, if a hospital handles “expected” punctures or lacerations correctly by not coding 998.2, the ratio of accidental punctures or lacerations per discharge will not be inappropriately diminished and will be more accurate.
What is the purpose of PSI-15?
Although PSI-15 currently is used in CMS programs that measure and report the quality and performance of hospitals, PSI-15 itself is a provider-level measure, which means that the results of PSI-15 can be attributed to the physician rather than the facility. At present, the results of PSI-15 are not separately reported as part ...
Is PSI 15 reported separately?
At present, the results of PSI-15 are not separately reported as part of these CMS quality programs; however, surgeons for whom PSI-15 is inappropriately reported could be affected based on how their facilities are conducting their internal quality improvement efforts.
What is the purpose of the PSI tool?
What is this tool? The purpose of this tool is to facilitate improvements to documentation and coding processes to ensure that PSI rates are accurate. The tool has two sections. The first describes procedures to address problems with documentation and coding practices among providers and hospital staff. The second illustrates some of the issues that can arise when documenting and coding each PSI.
Why do hospitals use CDI?
Many hospitals have implemented a CDI program to successfully enhance the quality of clinical data. The essential steps for achieving an effective CDI program are described in the UHC Clinical Documentation Challenges 2009 Field Book:
Why are there false positives in PSI?
These include coding of POA, miscoding, lack of coding specificity, coding of nonelective surgical admissions, and inaccurate coding of history of events.
