This measure assesses the number of patients diagnosed with confirmed VTE who received an overlap of Parenteral (intravenous [IV] or subcutaneous [subcu]) anticoagulation and warfarin therapy. For patients who received less than five days of overlap therapy, they should be discharged on both medications or have a Reason for Discontinuation of Parenteral Therapy. Overlap therapy should be administered for at least five days with an international normalized ratio (INR) greater than or equal to 2.0 prior to discontinuation of the parenteral anticoagulation therapy, or INR less than 2.0 but discharged on both medications or have a Reason for Discontinuation of Parenteral Therapy. This measure is part of a set of six prevention and treatment measures that address VTE (VTE-1: VTE Prophylaxis, VTE-2: ICU VTE Prophylaxis, VTE-4: VTE Patients Receiving UFH with Dosages/Platelet Count Monitoring, VTE-5: Warfarin Therapy Discharge Instructions and VTE-6: Hospital Acquired Potentially-Preventable VTE).
- Measure TypeElectronic Clinical Quality Measure (eCQM)Care SettingNumerator
Patients who received overlap therapy:
Included Populations: Patients who received warfarin and parenteral anticoagulation:
• Five or more days, with an INR greater than or equal to 2 prior to discontinuation of parenteral therapy OR
• Five or more days, with an INR less than 2 and discharged on overlap therapy OR
• Less than five days and discharged on overlap therapy OR
• With documentation of reason for discontinuation of overlap therapy OR
• With documentation of a reason for no overlap therapyDenominatorPatients with confirmed VTE who received warfarin. The target population includes patients discharged with an ICD-9-CM Principal or Other Diagnosis Codes for VTE as defined in Table 7.03 or Table 7.04.
Exclusions• Patients less than 18 years of age
• Patients who have a length of stay greater than 120 days
• Patients with Comfort Measures Only documented
• Patients enrolled in clinical trials
• Patients discharged to a health care facility for hospice care
• Patients discharged to home for hospice care
• Patients who expired
• Patients who left against medical advice
• Patients discharged to another hospital
• Patients without warfarin therapy during hospitalization
• Patients without VTE confirmed by diagnostic testing
- Measure StructureNon Condition SpecificTarget PopulationMeasure Selection AttributesNational Quality Strategy PrioritiesPatient Safety
- Risk Adjustment
- Current or planned use(s)Planned UseUse In Federal Program
- Most Recent Endorsement ActivityMeasure Retired and Endorsement Removed Patient Safety Fall Cycle 2020Initial EndorsementEndorsement StatusLast UpdatedRemoval Date
- StewardSteward Organization EmailSteward Organization Copyright
The Specifications Manual for National Hospital Inpatient Quality Measures (Specifications Manual) is the result of the collaborative efforts of the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission to publish a uniform set of national hospital quality measures. A primary objective of this collaborative effort is to promote and enhance the utility of these measures for all hospitals.
No royalty or use fee is required for copying or reprinting this manual, but the following are required as a condition of usage: 1) disclosure that the Specifications Manual is periodically updated, and that the version being copied or reprinted may not be up-to-date when used unless the copier or printer has verified the version to be up-to-date and affirms that, and 2) users participating in the QIO supported initiatives, the Hospital Inpatient Quality Reporting Program, and Joint Commission accreditation; including performance measures systems; are required to update their software and associated documentation based on the published manual production timelines.
Example Acknowledgement: The Specifications Manual for National Hospital Inpatient Quality Measures [Version xx, Month, Year] is the collaborative work of the Centers for Medicare & Medicaid Services and The Joint Commission. The Specifications Manual is periodically updated by the Centers for Medicare & Medicaid Services and The Joint Commission. Users of the Specifications Manual for National Hospital Inpatient Quality Measures must update their software and associated documentation based on the published manual production timelines.