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  1. Comments on eCQMs under development
  2. PCQM-838

Proposed change to metric to be patient-day based

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    • Recommend patients to be excluded
    • Melissa Weinberg, MD
    • 415-600-0110
    • Sutter Health, Diabetes Clinical Improvement Community
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      The change to make the severe hyperglycemia metric encounter-based, rather than by patient-day, does not incentivize continued high-quality glycemic care throughout the patient's hospitalization. Once a patient has a single glucose >300 mg/dL, they are counted in the numerator. This also gives equal weight in the denominator to patients with short stays vs those with longer stays. We believe that patient-day metrics give clinical teams the opportunity to provide the best diabetes care each and every day to patients. This approach is supported by many experts in glucometrics and the published literature.
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      The change to make the severe hyperglycemia metric encounter-based, rather than by patient-day, does not incentivize continued high-quality glycemic care throughout the patient's hospitalization. Once a patient has a single glucose >300 mg/dL, they are counted in the numerator. This also gives equal weight in the denominator to patients with short stays vs those with longer stays. We believe that patient-day metrics give clinical teams the opportunity to provide the best diabetes care each and every day to patients. This approach is supported by many experts in glucometrics and the published literature.
    • Hospital Harm - Severe Hyperglycemia

      We recommend the following patients be excluded from the hyperglycemia metric:

        • Comfort Care (it is appropriate to discontinue glucose checks in these patients)
        • Patients who refuse treatment (supports patient autonomy)
        • DKA/HHS (glucose >300 mg/dL can be appropriate clinical care in this situation)
        • Only 1 glucose value > 200 mg/dL and no other history of diabetes (typically reflects inaccurate measurement)
        • Organ donor patients (deceased)

            ataylor Albert W. Taylor
            SutterDCIC Melissa Weinberg (Inactive)
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