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  1. eCQM Issue Tracker
  2. CQM-5481

ED-2 Decision to Admit Patient Class & Location

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Answered
    • Icon: Moderate Moderate
    • Guidance, Measure
    • Katrina Houston
    • 951-203-5394
    • The Johns Hopkins Hospital
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      Thank you for the inquiry about CMS111v10 Median Admit Decision Time to ED Departure Time for Admitted Patients. The decision to admit to inpatient must be made during the ED Visit, prior to the ED Departure Time. Whether the patient in the scenario described in your inquiry would be included in the Measure Observation is dependent on your facility’s specific medical record workflow and processes after the patient is discharged from the hospital inpatient encounter. If your system combines the time the patient was in the ED and the time they were in observation into a single ED encounter so that there are not distinctly separate observation start and end times, but rather there are only ED arrival and departure times, and the decision to admit was made prior to the ED departure time, then the patient will be in the measure. If, however, your system does not combine the time the patient was in the ED and the time the patient was in observation into a single encounter, and there are distinctly separate ED arrival and departure times and observation start and end times, and the decision to admit was made after the ED departure time while in observation, then the patient will not be in the measure. Hope this helps.

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      Thank you for the inquiry about CMS111v10 Median Admit Decision Time to ED Departure Time for Admitted Patients. The decision to admit to inpatient must be made during the ED Visit, prior to the ED Departure Time. Whether the patient in the scenario described in your inquiry would be included in the Measure Observation is dependent on your facility’s specific medical record workflow and processes after the patient is discharged from the hospital inpatient encounter. If your system combines the time the patient was in the ED and the time they were in observation into a single ED encounter so that there are not distinctly separate observation start and end times, but rather there are only ED arrival and departure times, and the decision to admit was made prior to the ED departure time, then the patient will be in the measure. If, however, your system does not combine the time the patient was in the ED and the time the patient was in observation into a single encounter, and there are distinctly separate ED arrival and departure times and observation start and end times, and the decision to admit was made after the ED departure time while in observation, then the patient will not be in the measure. Hope this helps.
    • EH
    • CMS0111v10
    • Median time from ED Decision to Admit to ED Departure

      Regarding the ED-2 eCQM criteria of a decision to admit having to occur during the ED visit: 
      Does the decision to admit need to occur while the patient is classified STATUS as an ED patient or while the patient is PHYSICALLY located in the ED (what is the definition of 'during the ED visit')?

      For example: 
      A patient who is admitted from ED status to observation status while STILL physically located in the ED – would they be considered an ED patient or a non-ED patient when decision to admit to inpatient is then made at > 1 hour after the obs admission when they are obs STATUS but while the patient is still PHYSICALLY in the ED? Thank you!

            JLeflore Joelencia Leflore
            khouston Katrina Houston (Inactive)
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