Hi,

I just finished reviewing our 2024 Hybrid measure results. Our hospital failed to meet the IQR participation requirements due to a high number of patients "missing" a weight. After exploring further, most of these patients did have a weight taken on arrival to the ED. Thes patients arrive to our ED, get a weight taken, got admitted to the hospital under observation then 1-2 days later their patient class changed to inpatient. Apparently, the observation days are not being counted as the patients admission date even though they were always in an inpatient bed on an inpatient unit.  This measure's time clock starts when the patient class changed to inpatient. So, when the patients weight is taken in the ED, it is technically falling out of the 24hr prior to inpatient admission because there was an observation day  in-between ED arrival and Inpatient Admission time (but it's all the same hospital encounter). This is unfair.

You should be counting the patients first weight taken from ED arrival to 24 hours of inpatient admission time. Clinicians should not be penalized for a technicality in the billing process, especially if the patient's weight was obtained at the beginning of the encounter. It is unrealistic to expect the clinicians to retake a weight the next day to meet a measure when in reality the patient weight has likely unchanged.

Please, please, reconsider how this measure is designed for the mandatory reporting due this year (October 2024). Failing the IQR participation requirements for this is a hefty financial burden to hospitals!