2021 Definition Updates - mtqip
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2021 Definition Updates
Key
Indicator Meaning
Yellow Highlight New change
Red Text Variability compared to NTDS
Strike Deleted verbiage
Vendor flagKey
Indicator Meaning
Yellow Highlight New change
Red Text Variability compared to NTDS
Strike Deleted verbiage
Vendor flagKey
Indicator Meaning
Yellow Highlight New change
Red Text Variability compared to NTDS
Strike Deleted verbiage
Vendor flagKey
Indicator Meaning
Yellow Highlight New change
Red Text Variability compared to NTDS
Strike Deleted verbiage
Vendor flagStandardized sections and verbiage throughout the document.
FORMAT Addition of hyperlink resources. Corrected element values and
codebook reference to reflect current practice.
Rational – Document maintenance
2020 2021
CHEMOTHERAPY FOR CANCER CHEMOTHERAPY FOR CANCER
A patient who is currently receiving chemotherapy treatment for cancer prior to Definition
injury. Chemotherapy may include, but is not restricted to, oral and parenteral A patient who is currently receiving chemotherapy treatment for
treatment with chemotherapeutic agents for malignancies such as colon, breast, cancer.
lung, head and neck, and gastrointestinal solid tumors as well as lymphatic and
hematopoietic malignancies such as lymphomas, leukemia, and multiple myeloma. Element Values
Chemotherapy for Cancer (NTDS 5)
• Do not include if treatment consists solely of hormonal therapy.
Additional Information
Active Chemotherapy (NTDS 5) • Prior to injury.
Def. Source: NTDS • Chemotherapy may include, but is not restricted to, oral and
parenteral treatment with chemotherapeutic agents for
malignancies such as colon, breast, lung, head and neck, and
gastrointestinal solid tumors as well as lymphatic and hematopoietic
malignancies such as lymphomas, leukemia, and multiple myeloma.
• Exclude if treatment consists solely of hormonal therapy.
Resources
• Drug search
Codebook
Definition Source: NTDS
Data Base Column Name: A_COMORCODE
Type of Element: String
Length:
Report: #4Change log removed from end of dictionary. Converted to searchable
FORMAT
Excel document.
Rational - Document maintenance
2020 2021
CHANGE HISTORYHIGHEST ACTIVATION New variable.
Rational – NTDS update
Vendor Flag
2020 2021
HIGHEST ACTIVATION
Definition
Patient received the highest level of trauma activation at your hospital.
Element Values
1. Yes
2. No
Additional Information
• Highest level of activation is defined by your hospital’s criteria.
• Include patients who received the highest level of trauma activation
initiated by emergency medical services (EMS) or by emergency
department (ED) personnel at your hospital.
• Include patients who received the highest level of trauma activation
initiated by emergency medical services (EMS) or by emergency
department (ED) personnel at your hospital and were downgraded
after arrival to your center.
• Include patients who received a lower level of trauma activation
initiated by emergency medical services (EMS) or by emergency
department (ED) personnel at your hospital and were upgraded to
the highest level of trauma activation.
• Exclude patients who received the highest level of trauma
activation after emergency department (ED) discharge.
Resources
Codebook
Definition Source: NTDS
Data Base Column Name: HIGHESTTRAUMAACTIVATION
Type of Element: Numeric
Length: 1
Report: #1Variable renamed. Definition clarified to first trauma surgeon.
PROVIDER ARRIVAL DATE
Additional information added.
Rational – NTDS update
Vendor Flag
2020 2021
PROVIDER ARRIVAL DATE TRAUMA SURGEON ARRIVAL DATE
Definition Definition
The date of ED arrival of the trauma surgeon. The date the first trauma surgeon arrived at the patient’s bedside.
Element Values Element Values
• Relevant value for data element. • Relevant value for data element.
Additional Information Additional Information
• Reported as YYYY-MM-DD.
Resources • Limit reporting to the 24 hours after ED/Hospital arrival.
• The trauma surgeon leads the trauma team and is responsible for
Codebook the overall care of trauma patient, including coordinating care with
Definition Source: MTQIP other specialties and maintaining continuity of care.
Data Base Column Name: EDP_A_DATE01 • The null value “Not Applicable” is reported for those patients who
Type of Element: Date (MM/DD/YYYY Format) were not evaluated by a trauma surgeon within 24 hours of
Length: ED/Hospital arrival.
Report: #1 • Report for all full and partial activations. Trauma center discretion
for consults.
Resources
Codebook
Definition Source: NTDS
Data Base Column Name: EDP_A_DATE01
Type of Element: Date (MM/DD/YYYY Format)
Length:
Report: #1
Vendor mapping: Map partial activations to null value “Not
Applicable” for NTDS submission.Variable renamed. Definition clarified to first trauma surgeon.
PROVIDER ARRIVAL TIME
Additional information added.
Rational – NTDS update
Vendor Flag
2020 2021
PROVIDER ARRIVAL TIME TRAUMA SURGEON ARRIVAL TIME
Definition Definition
The time of ED arrival of the trauma surgeon. The time the first trauma surgeon arrived at the patient’s bedside.
Element Values Element Values
• Relevant value for data element. • Relevant value for data element.
Additional Information Additional Information
• Collected as HHMM military time.
Resources • Limit reporting to the 24 hours after ED/Hospital arrival.
• The trauma surgeon leads the trauma team and is responsible for
Codebook the overall care of trauma patient, including coordinating care with
Definition Source: MTQIP other specialties and maintaining continuity of care.
Data Base Column Name: EDP_A_TIME01 • The null value “Not Applicable” is reported for those patients who
Type of Element: Time (HH:MM Format) were not evaluated by a trauma surgeon within 24 hours of
Length: ED/Hospital arrival.
Report: #1 • The null value “Not Applicable” is reported if the data element
Highest Activation is reported as Element Value “2. No.”
• Report for all full and partial activations. Trauma center discretion
for consults.
Resources
Codebook
Definition Source: NTDS
Data Base Column Name: EDP_A_TIME01
Type of Element: Time (HH:MM Format)
Length:
Report: #1
Vendor mapping: Map partial activations to null value “Not
Applicable” for NTDS submission.EMS PATIENT CARE REPORT UNIQUE IDENTIFIER (UUID) New variable.
Rational – NTDS Update
Vendor Flag
2020 2021
EMS PATIENT CARE REPORT UNIQUE IDENTIFIER (UUID)
Definition
The patient’s universally unique identifier (UUID) as assigned by the
emergency medical service (EMS) agency transporting the patient
from the scene of injury to your hospital.
Element Values
• Relevant value for data element.
• Must be represented in canonical form, matching the following
regular expression: [a-fA-F0-9]{8}-[a-fA-F0-9]{4}-[1-5][a-fA-F0-9]{3}-
[89abAB][a-fA-F0-9]{3}-[a-fA-F0-9]{12}
Additional Information
• A sample UUID is: e48cd734-01cc-4da4-ae6a-915b0b1290f6
• Assigned by the transporting EMS agency in accordance with the
IETF RFC 4122 standard.
• The null value “Not Applicable” must be reported for all patients
where Interfacility Transfer is Element Value “1. Yes”.
• The null value “Not Known/Not Recorded” should be reported if the
UUID is not documented on the EMS Run Report or if the EMS
provider is not NEMSIS v3.5.0 compliant.
• The null value “Not Applicable” must be reported for all patients
where Transport Mode is Element Values “4. Private/Public
Vehicle/Walk-in”, “5. Police”, “6. Other” or if patient is not
transported from the scene of injury by EMS.
• For patients with multiple modes of transport from the scene of injury,
report the UUID assigned by the EMS agency that delivered the
patient to your hospital.
• Consistent with NEMSIS v3.5.0.
Resources
Codebook
Definition Source: NTDS
Data Base Column Name: LINKAGERECORDID
Type of Element: String
Length:
Report: #1SEX Added “3. Non-binary.”
Rational – NTDS update
Vendor Flag
2020 2021
SEX SEX
Definition Definition
The patient’s sex. The patient’s sex.
Element Values Element Values
1. Male (M) 1. Male (M)
2. Female (F) 2. Female (F)
3. Non-binary (N)
Additional Information
• Patients who have undergone a surgical and/or hormonal sex Additional Information
reassignment should be coded using the current assignment. • Patients who have undergone a surgical and/or hormonal sex
reassignment should be coded using the current assignment.
Resources
Resources
Codebook
Definition Source: NTDS Codebook
Data Base Column Name: SEX Definition Source: NTDS
Type of Element: String Data Base Column Name: SEX
Length: 1 Type of Element: String
Report: #1 Length: 1
Report: #1Added "Anticoagulant must be part of the patient's active
ANTICOAGULANT THERAPY medication.” Reworded exclusion for sole aspirin therapy as their
anticoagulant.
Rational – NTDS update
2020 2021
ANTICOAGULANT THERAPY ANTICOAGULANT THERAPY
Definition Definition
Documentation in the medical record of the administration of Documentation in the medical record of the administration of
medication (anticoagulants, antiplatelet agents, thrombin inhibitors, medication (anticoagulants, antiplatelet agents, thrombin inhibitors,
factor Xa inhibitors, thrombolytic agents) that interferes with blood factor Xa inhibitors, thrombolytic agents) that interferes with blood
clotting. clotting.
Element Values Element Values
• Anticoagulant Therapy (NTDS 31) • Anticoagulant Therapy (NTDS 31)
Additional Information Additional Information
• Present prior to injury. • Present prior to injury.
• Exclude patients who are on chronic Aspirin therapy. • Anticoagulant must be an active medication within provided time
• Utilize the associated discontinuation time frames below to frames below.
determine reporting for this element. • Exclude patients whose only anticoagulant therapy is chronic
aspirin.
Resources
• Drug search Resources
• Drug search
Codebook
Definition Source: NTDS Codebook
Data Base Column Name: A_COMORCODE Definition Source: NTDS
Type of Element: String Data Base Column Name: A_COMORCODE
Length: Type of Element: String
Report: #4 Length:
Report: #4EMS DISPATCH DATE Retired. Rational – NTDS update Vendor Flag 2020 2021 EMS DISPATCH DATE Definition The date the unit transporting to your hospital was notified by dispatch. Element Values • Relevant value for data element. Additional Information • Reported as YYYY-MM-DD. • For inter-facility transfer patients, this is the date on which the unit transporting the patient to your facility from the transferring facility was notified by dispatch or assigned to this transport. • For patients transported from the scene of injury to your hospital, this is the date on which the unit transporting the patient to your facility from the scene was dispatched. • The null value "Not Applicable" is reported for patients who were not transported by EMS. Resources Codebook Definition Source: NTDS Data Base Column Name: PHP_D_DATES_L (SCENE), ITP_D_DATES_L (INTERFACILITY TXFR) Type of Element: Date (MM/DD/YYYY Format) Length: Report: #1
EMS DISPATCH TIME Retired. Rational – NTDS update Vendor Flag 2020 2021 EMS DISPATCH TIME Definition The time the unit transporting to your hospital was notified by dispatch. Element Values • Relevant value for data element. Additional Information • Reported as HH:MM military time. • For inter-facility transfer patients, this is the time at which the unit transporting the patient to your facility from the transferring facility was notified by dispatch. • For patients transported from the scene of injury to your hospital, this is the time at which the unit transporting the patient to your facility from the scene was dispatched. • The null value "Not Applicable" is reported for patients who were not transported by EMS. Resources Codebook Definition Source: NTDS Data Base Column Name: PHP_D_TIMES_L (SCENE), ITP_D_TIMES_L (INTERFACILITY TXFR) Type of Element: Time (HH:MM Format) Length: Report: #1
EMS UNIT ARRIVAL DATE AT SCENE OR TRANSFERRING FACILITY Retired. Rational – NTDS update Vendor Flag 2020 2021 EMS UNIT ARRIVAL DATE AT SCENE OR TRANSFERRING FACILITY Definition The date the unit transporting to your hospital arrived on the scene/transferring facility. Element Values • Relevant value for data element. Additional Information • Reported as YYYY-MM-DD. • For inter-facility transfer patients, this is the date on which the unit transporting the patient to your facility from the transferring facility arrived at the transferring facility (arrival is defined at date/time when the vehicle stopped moving). • For patients transported from the scene of injury to your hospital, this is the date on which the unit transporting the patient to your facility from the scene arrived at the scene (arrival is defined at date/time when the vehicle stopped moving). • The null value "Not Applicable" is reported for patients who were not transported by EMS. Resources Codebook Definition Source: NTDS Data Base Column Name: PHP_A_DATES_L (SCENE), ITP_A_DATES_L (INTERFACILITY TRANFER) Type of Element: Date (MM/DD/YYYY Format) Length: Report: #1
EMS UNIT ARRIVAL TIME AT SCENE OR TRANSFERRING FACILITY Retired. Rational – NTDS update Vendor Flag 2020 2021 EMS UNIT ARRIVAL TIME AT SCENE OR TRANSFERRING FACILITY Definition The time the unit transporting to your hospital arrived on the scene/transferring facility. Element Values • Relevant value for data element. Additional Information • Reported as HH:MM military time. • For inter-facility transfer patients, this is the time at which the unit transporting the patient to your facility from the transferring facility arrived at the transferring facility (arrival is defined at date/time when the vehicle stopped moving). • For patients transported from the scene of injury to your hospital, this is the time at which the unit transporting the patient to your facility from the scene arrived at the scene (arrival is defined at date/time when the vehicle stopped moving). • The null value "Not Applicable" is reported for patients who were not transported by EMS. Resources Codebook Definition Source: NTDS Data Base Column Name: PHP_A_TIMES_L (SCENE), ITP_A_TIMES_L (INTERFACILITY TRANSFER) Type of Element: Time (HH:MM Format) Length: Report: #1
EMS UNIT DEPARTURE DATE FROM SCENE OR TRANSFERRING FACILITY Retired. Rational – NTDS update Vendor Flag 2020 2021 EMS UNIT DEPARTURE DATE FROM SCENE OR TRANSFERRING FACILITY Definition The date the unit transporting to your hospital left the scene/transferring facility. Element Values • Relevant value for data element. Additional Information • Reported as YYYY-MM-DD. • For inter-facility transfer patients, this is the date on which the unit transporting the patient to your facility from the transferring facility departed from the transferring facility (departure is defined at date/time when the vehicle started moving). • For patients transported from the scene of injury to your hospital, this is the date on which the unit transporting the patient to your facility from the scene departed from the scene (departure is defined at date/time when the vehicle started moving). • The null value "Not Applicable" is reported for patients who were not transported by EMS. Resources Codebook Definition Source: NTDS Data Base Column Name: PHP_L_DATES_L (SCENE), ITP_L_DATES_L (INTERFACILITY TRANSFER) Type of Element: Date (MM/DD/YYYY Format) Length: Report: #1
EMS UNIT DEPARTURE TIME FROM SCENE OR TRANSFERRING FACILITY Retired. Rational – NTDS update Vendor Flag 2020 2021 EMS UNIT DEPARTURE TIME FROM SCENE OR TRANSFERRING FACILITY Definition The time the unit transporting to your hospital left the scene/transferring facility. Element Values • Relevant value for data element. Additional Information • Reported as HH:MM military time. • For inter-facility transfer patients, this is the time at which the unit transporting the patient to your facility from the transferring facility departed from the transferring facility (departure is defined at date/time when the vehicle started moving). • For patients transported from the scene of injury to your hospital, this is the time at which the unit transporting the patient to your facility from the scene departed from the scene (departure is defined at date/time when the vehicle started moving). • The null value "Not Applicable" is reported for patients who were not transported by EMS. Resources Codebook Definition Source: NTDS Data Base Column Name: PHP_L_TIMES_L (SCENE), ITP_L_TIMES_L (INTERFACILITY TRANSFER) Type of Element: Time (HH:MM Format) Length: Report: #1
INITIAL FIELD SYSTOLIC BLOOD PRESSURE Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD SYSTOLIC BLOOD PRESSURE Definition First recorded systolic blood pressure measured at the scene of injury. Element Values • Relevant value for data element. Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • Measurement recorded must be without the assistance of CPR or any type of mechanical chest compression device. For those patients who are receiving CPR or any type of mechanical chest compressions, report the value obtained while compressions are paused. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field systolic blood pressure was NOT measured at the scene of injury. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_SBPS_L Type of Element: Numeric Length: Report: #1
INITIAL FIELD PULSE RATE Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD PULSE RATE Definition First recorded pulse measured at the scene of injury (palpated or auscultated), expressed as a number per minute. Element Values • Relevant value for data element. Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • Measurement recorded must be without the assistance of CPR or any type of mechanical chest compression device. For those patients who are receiving CPR or any type of mechanical chest compressions, report the value obtained while compressions are paused. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field pulse rate was NOT measured at the scene of injury. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_PULSES_L Type of Element: Numeric Length: Report: #1
INITIAL FIELD RESPIRATORY RATE Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD RESPIRATORY RATE Definition First recorded respiratory rate measured at the scene of injury (expressed as a number per minute). Element Values • Relevant value for data element. Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field respiratory rate was NOT measured at the scene of injury. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_URRS_L (PRE-HOSPITAL UNASSISTED), PHAS_ARRS_L (PRE-HOSPITAL ASSISTED) Type of Element: Numeric Length: Report: #1
INITIAL FIELD OXYGEN SATURATION Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD OXYGEN SATURATION Definition First recorded oxygen saturation measured at the scene of injury (expressed as a percentage). Element Values • Relevant value for data element. Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • Value should be based upon assessment before administration of supplemental oxygen. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field oxygen saturation was NOT measured at the scene of injury. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_SA02S_L Type of Element: Numeric Length: Report: #1
INITIAL FIELD GCS EYE Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS – EYE Definition First recorded Glasgow Coma Score (Eye) measured at the scene of injury. Element Values 1. No eye movement when assessed 2. Opens eyes in response to painful stimulation 3. Opens eyes in response to verbal stimulation 4. Opens eyes spontaneously Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If a patient does not have a numeric GCS score recorded, but written documentation closely (or directly) relates to verbiage describing a specific level of functioning within the GCS scale, the appropriate numeric score may be listed. E.g. the chart indicates: "patient's pupils are PERRL," an Eye GCS of 4 may be recorded, IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS - Eye was NOT measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS 40 – Eye is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_GCS_EOS_L Type of Element: Numeric Length: Report: #1
INITIAL FIELD GCS VERBAL Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS – VERBAL Definition First recorded Glasgow Coma Score (Verbal) measured at the scene of injury. Element Values 1. No verbal response 2. Incomprehensible sounds 3. Inappropriate words 4. Confused 5. Oriented Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If patient is intubated, then the GCS Verbal score is equal to 1. • If a patient does not have a numeric GCS score recorded, but written documentation closely (or directly) relates to verbiage describing a specific level of functioning within the GCS scale, the appropriate numeric score may be listed. E.g. the chart indicates: "patient is oriented to person place and time," a Verbal GCS of 5 may be recorded, IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS - Verbal was NOT measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS 40 - Verbal is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_GCS_VRS_L
INITIAL FIELD GCS MOTOR Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS – MOTOR Definition First recorded Glasgow Coma Score (Motor) measured at the scene of injury. Element Values 1. No motor response 2. Extension to pain 3. Flexion to pain 4. Withdrawal from pain 5. Localizing pain 6. Obeys commands Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If a patient does not have a numeric GCS score recorded, but written documentation closely (or directly) relates to verbiage describing a specific level of functioning within the GCS scale, the appropriate numeric score may be listed. E.g. the chart indicates: "patient withdraws from a painful stimulus," a Motor GCS of 4 may be recorded, IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS - Motor was NOT measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS 40 - Motor is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_GCS_MRS_L Report: #1
INITIAL FIELD GCS TOTAL Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS – TOTAL Definition First recorded Glasgow Coma Score (total) measured at the scene of injury. Element Values • Relevant value for data element. Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If a patient does not have a numeric GCS recorded, but there is documentation related to their level of consciousness such as "AAOx3," "awake alert and oriented," or "patient with normal mental status," interpret this as GCS of 15 IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by 4. Private/Public Vehicle/Walk-in. • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS - Total was NOT measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS 40 is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: PHAS_GCSSC_L Type of Element: Numeric Length: Report: #1
INITIAL FIELD GCS 40 EYE Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS 40 – EYE Definition First recorded Glasgow Coma Score 40 (Eye) measured at the scene of injury. Element Values 1. Not Testable 2. None 3. To Pressure 4. To Sound 5. Spontaneous Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If a patient does not have a numeric GCS score recorded, but written documentation closely (or directly) relates to verbiage describing a specific level of functioning within the GCS 40 scale, the appropriate numeric score may be listed. E.g. the chart indicates: "patient's eyes open spontaneously," an Eye GCS 40 of 4 may be recorded, IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by “4. Private/Public Vehicle/Walk-in.” • Report Element Value “0. Not Testable” if unable to assess (e.g. swelling to eye(s)). • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS 40 – Eye was NOT measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS – Eye is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: EMSGCS40EYE
INTIIAL FIELD GCS 40 VERBAL Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS 40 – VERBAL Definition First recorded Glasgow Coma Score 40 (Verbal) measured at the scene of injury. Element Values 1. Not Testable 2. None 3. Sounds 4. Words 5. Confused 6. Oriented Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If a patient does not have a numeric GCS 40 score recorded, but written documentation closely (or directly) relates to verbiage describing a specific level of functioning within the GCS 40 scale, the appropriate numeric score may be listed. E.g. the chart indicates: "patient correctly gives name, place and date" a Verbal GCS of 5 may be recorded, IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by “4. Private/Public Vehicle/Walk-in”. • Report Element Value “0. Not Testable” if unable to assess (e.g. patient is intubated). • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS 40-Verbal was not measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS – Verbal is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: EMSGCS40VERBAL
INITIAL FIELD GCS 40 MOTOR Retired. Rational – NTDS update Vendor Flag 2020 2021 INITIAL FIELD GCS 40 – MOTOR Definition First recorded Glasgow Coma Score 40 (Motor) measured at the scene of injury. Element Values 0. Not Testable 1. None 2. Extension 3. Abnormal Flexion 4. Normal Flexion 5. Localizing 6. Obeys Commands Additional Information • The null value "Not Known/Not Recorded" is reported if the patient is transferred to your facility with no EMS Run Report from the scene of injury. • If a patient does not have a numeric GCS 40 score recorded, but written documentation closely (or directly) relates to verbiage describing a specific level of functioning within the GCS scale, the appropriate numeric score may be listed. E.g. the chart indicates: "patient opened mouth and stuck out tongue when asked" for adult patient’s, a Motor GCS 40 of 6 may be recorded, IF there is no other contradicting documentation. • The null value "Not Applicable" is reported for patients who arrive by “4. Private/Public Vehicle/Walk-in”. • Report Element Value “0. Not Testable” if unable to assess (e.g. neuromuscular blockade). • The null value “Not Known/Not Recorded” is reported if the patient’s first recorded initial field GCS 40 – motor was NOT measured at the scene of injury. • The null value “Not Known/Not Recorded” is reported if Initial Field GCS – Motor is reported. Resources Codebook Definition Source: NTDS Data Base Column Name: EMSGCS40MOTOR
Updated definition "Chronic obstructive pulmonary disease (COPD) is a
lung disease characterized by chronic obstruction of lung airflow that
interferes with normal breathing and is not fully reversible. The more
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
familiar terms 'chronic bronchitis' and 'emphysema' are no longer used
but are now included within the COPD diagnosis.” Updated source:
World Health Organization (WHO), 2019.
Rational – NTDS update
2020 2021
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
Definition Definition
Lung ailment that is characterized by a persistent blockage of airflow Chronic obstructive pulmonary disease is a lung disease that is
from the lungs, present prior to injury. It is not one single disease, but an characterized by a persistent blockage of airflow that interferes with
umbrella term used to describe chronic lung diseases that cause normal breathing and is not fully reversible. The more familiar terms
limitations in lung airflow. The more familiar terms "chronic bronchitis" “chronic bronchitis" and "emphysema" are no longer used but are now
and "emphysema" are no longer used, but are now included within the included within the COPD diagnosis.
COPD diagnosis and result in any one or more of the following:
Element Values
1. Functional disability from COPD (e.g., dyspnea, inability to perform Chronic Obstructive Pulmonary Disease (NTDS 23)
activities of daily living [ADLs])
2. Hospitalization in the past for treatment of COPD Additional Information
3. Requires chronic scheduled or prn bronchodilator therapy with oral • Reporting criteria (1 or more required)
or inhaled agents • Functional disability from COPD (e.g., dyspnea, inability to
4. A Forced Expiratory Volume in 1 second (FEV1) of perform activities of daily living [ADLs])
• Hospitalization in the past for treatment of COPD
Element Values • Requires chronic scheduled or prn bronchodilator therapy
Chronic Obstructive Pulmonary Disease (NTDS 23) with oral or inhaled agents
• A Forced Expiratory Volume in 1 second (FEV1) ofVendor mapping request for patients discharged on same day as
HIGHEST GCS TOTAL
arrival.
Rational – NTDS update
Vendor Flag
2020 2021
HIGHEST GCS TOTAL HIGHEST GCS TOTAL
Definition Definition
Highest total GCS within 24 hours of ED/hospital arrival. Highest total GCS within 24 hours of ED/hospital arrival.
Element Values Element Values
• Relevant value for data element. • Relevant value for data element.
Additional Information Additional Information
• Refers to highest total GCS within 24 hours after ED Hospital/Arrival to • Refers to highest total GCS within 24 hours after ED Hospital/Arrival to
index hospital, where index hospital is the hospital abstracting the index hospital, where index hospital is the hospital abstracting the
data. data.
• Requires review of all data sources to obtain the highest GCS total. • Requires review of all data sources to obtain the highest GCS total.
In many cases, the highest GCS may occur after ED discharge. In many cases, the highest GCS may occur after ED discharge.
• The provider evaluation time, staff arrived time, and similar • The provider evaluation time, staff arrived time, and similar
assessment time should be used when the specified provider’s note assessment time should be used when the specified provider’s note
documents this assessment. documents this assessment.
• If patient is intubated, then the GCS Verbal score is equal to 1. • If patient is intubated, then the GCS Verbal score is equal to 1.
• Best obtained when sedatives or paralytics are withheld as part of • Best obtained when sedatives or paralytics are withheld as part of
sedation holiday. sedation holiday.
• If a patient does not have a numeric GCS recorded, but there is • If a patient does not have a numeric GCS recorded, but there is
documentation related to their level of consciousness such as documentation related to their level of consciousness such as
"AAOx3," "awake alert and oriented," or "patient with normal mental "AAOx3," "awake alert and oriented," or "patient with normal mental
status," interpret this as GCS of 15 IF there is no other contradicting status," interpret this as GCS of 15 IF there is no other contradicting
documentation. documentation.
• The null value "Not Applicable" is reported for patients that do not • The null value "Not Applicable" is reported for patients that do not
meet reporting criteria. meet reporting criteria.
• The null value “Not Known/Not Recorded” is reported if reporting • The null value “Not Known/Not Recorded” is reported if reporting
Highest GCS Motor 40. Highest GCS Motor 40.
Resources Resources
Codebook Codebook
Definition Source: TQIP Definition Source: TQIP
Data Base Column Name: MTQIP_TBI_GCS_H Data Base Column Name: MTQIP_TBI_GCS_H
Type of Element: Numeric Type of Element: Numeric
Length: 2 Length: 2
Report: #1 Report: #1
Vendor Mapping: If patient was discharged on the same date as
ED/Hospital Arrival Date map to “Not Applicable” for NTDS submission.Changed to injury diagnoses as defined by ICD-10-CM code range S00-
ICD-10 INJURY DIAGNOSES
S99, T07, T14, T79.A1-T79.A9.
Rational – NTDS update
2020 2021
ICD-10 INJURY DIAGNOSES ICD-10 INJURY DIAGNOSES
Definition Definition
Diagnoses related to all identified injuries. Diagnoses related to all identified injuries.
Element Values Element Values
• Injury diagnoses as defined by ICD-10-CM code range S00-S99, T07, • Injury diagnoses as defined by ICD-10-CM code range S00-S99, T07,
T14, T20-T28 and T30-T32. T14, T79.A1-T79.A9.
• The maximum number of diagnoses that may be reported for an • The maximum number of diagnoses that may be reported for an
individual patient is 50. individual patient is 50.
Additional Information Additional Information
• ICD-10-CM codes pertaining to other medical conditions (e.g., CVA, • ICD-10-CM codes pertaining to other medical conditions (e.g., CVA,
MI, co-morbidities, etc.) may also be included in this element. MI, co-morbidities, etc.) may also be included in this element.
• The null value "Not Applicable" is used if not coding ICD-10.
Resources
Resources
Codebook
Codebook Definition Source: NTDS
Definition Source: NTDS Data Base Column Name: A_DCODE, A_DCODE_AS_TEXT
Data Base Column Name: A_DCODE, A_DCODE_AS_TEXT Type of Element: String
Type of Element: String Length: 6
Length: 6 Report: #2
Report: #2Updated verbiage from calendar days to consecutive days. Addition of
CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI)
3 signs and symptoms that can be used for reporting.
Rational – NTDS update
2020 2021
CATHETER-ASSOCIATED URINARY TRACT INFECTION CATHETER-ASSOCIATED URINARY TRACT INFECTION
Definition Definition
A UTI where an indwelling urinary catheter was in place for > 2 calendar A urinary tract infection (UTI) where an indwelling urinary catheter was
days on the date of event, with day of device placement being Day 1, in place for > 2 calendar days on the date of event, with day of device
placement being Day 1,
AND
AND
An indwelling urinary catheter was in place on the date of event or the
day before. If an indwelling urinary catheter was in place for > 2 An indwelling urinary catheter was in place on the date of event or the
calendar days and then removed, the date of event for the UTI must be day before. If an indwelling urinary catheter was in place for > 2
the day of discontinuation or the next day for the UTI to be catheter- consecutive days in an inpatient location and then removed, the date
associated. of event for the UTI must be the day of device discontinuation or the
next day for the UTI to be catheter-associated.
Patient must meet 1, 2, and 3 below:
Patient must meet 1, 2, and 3 below:
1. Patient has an indwelling urinary catheter in place for the
entire day on the date of event and such catheter had 1. Patient has an indwelling urinary catheter in place for more
been in place for >2 calendar days, on that date (day of than 2 consecutive days in an inpatient location on the
device placement = Day 1) AND was either: date of event AND was either:
1. Present for any portion of the calendar day on the 1. Present for any portion of the calendar day on the
date of event, OR date of event, OR
2. Removed the day before the date of event 2. Removed the day before the date of event
2. Patient has at least one of the following signs or symptoms: 2. Patient has at least one of the following signs or symptoms:
1. Fever (>38C) 1. Fever (>38C)
2. Suprapubic tenderness with no other recognized 2. Suprapubic tenderness
cause 3. Costovertebral angle pain or tenderness
3. Costovertebral angle pain or tenderness with no 4. Urinary urgency
other recognized cause 5. Urinary frequency
3. Patient has a urine culture with no more than two species 6. Dysuria
of organisms, at least one of which is bacteria >105 CFU/ml. 3. Patient has a urine culture with no more than two species
of organisms, at least one of which is bacterium >105
CFU/ml.NTDS PATIENT INCLUSION CRITERIA Removed ICD-10-CM: T20-T28 and T30-T32 CODES
Rational – NTDS update
2020 2021
PATIENT INCLUSION CRITERIA PATIENT INCLUSION CRITERIA
Definition Definition
To ensure consistent data reporting across States into the National To ensure consistent data reporting across States into the National
Trauma Data Standard, a trauma patient is defined as a patient Trauma Data Standard, a trauma patient is defined as a patient
sustaining a traumatic injury within 14 days of initial hospital encounter sustaining a traumatic injury within 14 days of initial hospital encounter
and meeting the following criteria: and meeting the following criteria:
At least one of the following injury diagnostic codes defined as follows: At least one of the following injury diagnostic codes defined as follows:
International Classification of Diseases, Tenth Revision (ICD-10-CM): International Classification of Diseases, Tenth Revision (ICD-10-CM):
• S00-S99 with 7th character modifiers of A, B, or C ONLY. (Injuries to • S00-S99 with 7th character modifiers of A, B, or C ONLY. (Injuries to
specific body parts - initial encounter) specific body parts - initial encounter)
• T07 (unspecified multiple injuries) • T07 (unspecified multiple injuries)
• T14 (injury of unspecified body region) • T14 (injury of unspecified body region)
• T20-T28 with 7th character modifier of A ONLY (burns by specific • T79.A1-T79.A9 with 7th character modifier of A ONLY (Traumatic
body parts – initial encounter) Compartment Syndrome – initial encounter)
• T30-T32 (burn by TBSA percentages)
• T79.A1-T79.A9 with 7th character modifier of A ONLY (Traumatic Excluding the following isolated injuries:
Compartment Syndrome – initial encounter) ICD-10-CM:
Excluding the following isolated injuries: • S00 (Superficial injuries of the head)
ICD-10-CM: • S10 (Superficial injuries of the neck)
• S20 (Superficial injuries of the thorax)
• S00 (Superficial injuries of the head) • S30 (Superficial injuries of the abdomen, pelvis, lower back and
• S10 (Superficial injuries of the neck) external genitals)
• S20 (Superficial injuries of the thorax) • S40 (Superficial injuries of shoulder and upper arm)
• S30 (Superficial injuries of the abdomen, pelvis, lower back and • S50 (Superficial injuries of elbow and forearm)
external genitals) • S60 (Superficial injuries of wrist, hand and fingers)
• S40 (Superficial injuries of shoulder and upper arm) • S70 (Superficial injuries of hip and thigh)
• S50 (Superficial injuries of elbow and forearm) • S80 (Superficial injuries of knee and lower leg)
• S60 (Superficial injuries of wrist, hand and fingers) • S90 (Superficial injuries of ankle, foot and toes)
• S70 (Superficial injuries of hip and thigh)
• S80 (Superficial injuries of knee and lower leg) Late effect codes, which are represented using the same range of
• S90 (Superficial injuries of ankle, foot and toes) injury diagnosis codes but with the 7th digit modifier code of D through
S, are also excluded.
Late effect codes, which are represented using the same range of
injury diagnosis codes but with the 7th digit modifier code of D through AND MUST INCLUDE ONE OF THE FOLLOWING IN ADDITION TO (ICD-10-
S, are also excluded. CM S00-S99, T07, T14 and T79.A1-T79.A9):
AND MUST INCLUDE ONE OF THE FOLLOWING IN ADDITION TO (ICD-10-
CM S00-S99, T07, T14, T20-T28, T30-T32 and T79.A1-T79.A9):Vendor edit check request. A populated element must be 10
TRAUMA SURGEON characters in length. A populated NPI element cannot contain non-
numeric values.
Rational – Errors in transmitted data
Vendor Flag
2020 2021
TRAUMA SURGEON TRAUMA SURGEON
Definition Definition
Report the name and National Provider Identifier (NPI) of the trauma Report the name and National Provider Identifier (NPI) of the trauma
surgeon providing initial care to the patient in the ED and on admission. surgeon providing initial care to the patient in the ED and on admission.
Element Values Element Values
• Relevant value for data element. • Relevant value for data element.
Additional Information Additional Information
Resources Resources
• NPI Registry • NPI Registry
Codebook Codebook
Definition Source: MTQIP Definition Source: MTQIP
Data Base Column Name (Resus Trauma Surgeons): EDP_MD_LNK01, Data Base Column Name (Resus Trauma Surgeons): EDP_MD_LNK01,
EDP_MD_LNK01_AS_TEXT, EDP_MD_LNK01_NPI EDP_MD_LNK01_AS_TEXT, EDP_MD_LNK01_NPI
Data Base Column Name (Admitting Trauma Surgeons): TSPHCODE, Data Base Column Name (Admitting Trauma Surgeons): TSPHCODE,
TSPHCODE_AS_TEXT, TSPHCODE_NPI TSPHCODE_AS_TEXT, TSPHCODE_NPI
Type of Element: String, String, Numeric Type of Element: String, String, Numeric
Length: Length:
Report: #1 Report: #1
Vendor edit check: A populated NPI element must be 10 characters in
length. A populated NPI element cannot contain non-numeric values.PATIENT’S TELEPHONE NUMBER New variable.
Rational – Patient-reported outcomes quality improvement
Vendor Flag
2020 2021
PATIENT’S TELEPHONE NUMBER
Definition
The patient’s telephone number.
Element Values
• Relevant value for data element.
Additional Information
Resources
Codebook
Definition Source: MTQIP
Data Base Column Name: PATIENT_PHONE
Type of Element: Numeric
Length: 10
Report: #1
Vendor edit check: A populated element must be 10 characters in
length. A populated element cannot contain non-numeric values.Clarified to only include clots in the venous vascular system. Clarified to
DEEP VEIN THROMBOSIS (DVT)
include cases who die before treatment can be initiated.
Rational – MTQIP Member request
2020 2021
DEEP VEIN THROMBOSIS (DVT) DEEP VEIN THROMBOSIS (DVT)
Definition Definition
The formation, development, or existence of a blood clot or thrombus The formation, development, or existence of a blood clot or thrombus
within the vascular system, which may be coupled with inflammation. within the venous vascular system, which may be coupled with
inflammation.
Element Values
Deep Vein Thrombosis (NTDS 14) Element Values
Deep Vein Thrombosis (NTDS 14)
Additional Information
• Patients with DVT treated with anticoagulation therapy and/or Additional Information
placement of a vena cava filter or clipping of the vena cava. • Patients with DVT treated with anticoagulation therapy and/or
• The diagnosis may be confirmed by venogram, ultrasound, or CT placement of a vena cava filter or clipping of the vena cava.
scan. • The diagnosis may be confirmed by venogram, ultrasound, or CT
• Patients with DVT where the attending physician documents scan.
therapeutic anticoagulation contraindication due to bleeding risk. • Patients with DVT where the attending physician documents
• Patients with gastrocnemius or soleus vein thromboses if the patient therapeutic anticoagulation contraindication due to bleeding risk.
receives treatment or contraindication is documented. • Patients with gastrocnemius or soleus vein thromboses if the patient
• Patients with non-extremity deep vein thromboses such as portal or receives treatment or contraindication is documented.
internal jugular vein if the patient receives treatment or • Patients with non-extremity deep vein thromboses such as portal or
contraindication is documented. internal jugular vein if the patient receives treatment or
• Exclude thrombosis of superficial veins of the upper or lower contraindication is documented.
extremities, such as the cephalic or greater saphenous vein. • Include if positive for DVT but expired before treatment can be
• Exclude patients with no documented contraindication who only instituted.
receive aspirin for treatment. • Exclude thrombosis of superficial veins of the upper or lower
extremities, such as the cephalic or greater saphenous vein.
Resources • Exclude patients with no documented contraindication who only
• Veins of the Lower Extremity receive aspirin for treatment.
• Veins of the Upper Extremity
Resources
Codebook • Veins of the Lower Extremity
Definition Source: NTDS • Veins of the Upper Extremity
Data Base Column Name: A_TCODE, A_TCODE_AS_TEXT
Type of Element: String Codebook
Length: Definition Source: NTDS
Report: #6 Data Base Column Name: A_TCODE, A_TCODE_AS_TEXT
Type of Element: String
Length:
Report: #6ED TRAUMA RESPONSE Clarified inclusion of orders such as trauma consult.
Rational – MTQIP Member request
2020 2021
ED TRAUMA RESPONSE ED TRAUMA RESPONSE
Definition Definition
Enter the final level of response being provided to the patient in the Enter the final level of response being provided to the patient in the
Emergency Department (ED) by trauma. Emergency Department (ED) by trauma.
Element Values Element Values
1. Full activation 1. Full activation
2. Partial activation 2. Partial activation
3. Trauma consult 3. Trauma consult
4. None 4. None
Additional Information Additional Information
• Trauma is called by the ED to see a patient in the ED and a provider • Trauma is called by the ED to see a patient in the ED and a provider
from the service sees the patient, report as consult. from the service sees the patient, report as consult.
• Patient arrives as a full activation, but is downgraded to a partial • Patient arrives as a full activation, but is downgraded to a partial
activation, report as a partial activation. activation, report as a partial activation.
• Patient arrives as partial activation, but is upgraded to a full • Patient arrives as partial activation, but is upgraded to a full
activation, report as a full activation. activation, report as a full activation.
• Include patients with an order entered. For example, an ED provider
Resources enters a consult order for trauma consultation, report as trauma
consult.
Codebook
Definition Source: MTQIP Resources
Data Base Column Name: ED_TTA_TYPE, ED_TTA_TYPE_AS_TEXT
Type of Element: Numeric, String Codebook
Length: 1,8 Definition Source: MTQIP
Report: #1 Data Base Column Name: ED_TTA_TYPE, ED_TTA_TYPE_AS_TEXT
Type of Element: Numeric, String
Length: 1,8
Report: #1PULMONARY EMBOLISM Clarified inclusion of segmental PE’s. Clarified inclusion of fat embolism.
Rational – MTQIP Member request
2020 2021
PULMONARY EMBOLISM PULMONARY EMBOLISM
Definition Definition
A lodging of a blood clot in the pulmonary artery with subsequent A lodging of a blood clot in the pulmonary artery with subsequent
obstruction of blood supply to the lung parenchyma. The blood clots obstruction of blood supply to the lung parenchyma. The blood clots
usually originate from the deep leg veins or the pelvic venous system. usually originate from the deep leg veins or the pelvic venous system.
Element Values Element Values
Pulmonary Embolism (NTDS 21) Pulmonary Embolism (NTDS 21)
Additional Information Additional Information
• Consider the condition present if the patient has a V-Q scan • Consider the condition present if the patient has a V-Q scan
interpreted as high probability of pulmonary embolism or a positive interpreted as high probability of pulmonary embolism or a positive
pulmonary arteriogram or positive CT angiogram. pulmonary arteriogram or positive CT angiogram.
• Exclude subsegmental PE’s. • Include pulmonary imaging positive for fat embolism.
• Include segmental PE’s.
Resources • Exclude subsegmental PE’s.
Codebook Resources
Definition Source: NTDS
Data Base Column Name: A_TCODE, A_TCODE_AS_TEXT Codebook
Type of Element: String Definition Source: NTDS
Length: Data Base Column Name: A_TCODE, A_TCODE_AS_TEXT
Report: #6 Type of Element: String
Length:
Report: #6HOSPITAL EVENTS Clarified end of stay.
Rational – Data variability
2020 2021
INTRODUCTION INTRODUCTION
Definition Definition
Any medical complication that occurred during the patient's stay at Any medical complication that occurred during the patient's stay at
your hospital. your hospital.
Element Values Element Values
• Relevant value for data element. • Relevant value for data element.
Additional Information Additional Information
• The patient's stay begins on arrival to the emergency department. • The patient's stay begins on arrival to the emergency department.
• Do not include reported complications that are present prior to • Do not include reported complications that are present prior to
arrival. For example, a patient arrives with a urinary tract infection as arrival. For example, a patient arrives with a urinary tract infection as
indicated by symptoms present in documentation obtained on indicated by symptoms present in documentation obtained on
arrival and a culture obtained on arrival. arrival and a culture obtained on arrival.
• Do not report contaminants that did not require treatment for • Do not report contaminants that did not require treatment for
infectious events. For example, a patient has a BAL or blood culture infectious events. For example, a patient has a BAL or blood culture
that demonstrates contaminant and therapy is not provided. If a that demonstrates contaminant and therapy is not provided. If a
provider documents a contaminant, but treatment is provided the provider documents a contaminant, but treatment is provided the
event is reported. event is reported.
• The null value "Not Applicable" should be used for patients with no • For hospitals with an inpatient hospice service/unit without transition
complications. indicators in the EMR (e.g., new encounter/visit number, discharge
order, discharge summary, new admit order, new hospice service
Resources assignment, new hospice specific attending provider, etc.) to signal
the end of the patient’s stay, the end of stay occurs when the acute
Codebook phase of care ends. This does not include comfort care status
Definition Source: NTDS during the acute phase of care or transfer to medicine services
Data Base Column Name: Not applicable during the acute phase of care.
Type of Element: Not applicable • The null value "Not Applicable" should be used for patients with no
Length: Not applicable complications.
Report: #6
Resources
Codebook
Definition Source: NTDS
Data Base Column Name: Not applicable
Type of Element: Not applicable
Length: Not applicable
Report: #6HOSPITAL DISCHARGE DATE Clarified end of stay.
Rational – Data variability
2020 2021
HOSPITAL DISCHARGE DATE HOSPITAL DISCHARGE DATE
Definition Definition
The date the patient was discharged from the hospital. The date the patient was discharged from the hospital.
Element Values Element Values
• Relevant value for data element. • Relevant value for data element.
Additional Information Additional Information
• Reported as YYYY-MM-DD. • Reported as YYYY-MM-DD.
• The null value "Not Applicable" is reported if ED Discharge Disposition • The null value "Not Applicable" is reported if ED Discharge Disposition
= 4, 5, 6, 9, 10, or 11. = 4, 5, 6, 9, 10, or 11.
• If Hospital Discharge Disposition is Element Value “5 • If Hospital Discharge Disposition is Element Value “5
Deceased/Expired,” then the Hospital Discharge Date is the date of Deceased/Expired,” then the Hospital Discharge Date is the date of
death as indicated on the patient’s death certificate. death as indicated on the patient’s death certificate.
• For hospitals with an inpatient hospice service/unit without transition
Resources indicators in the EMR (e.g., new encounter/visit number, discharge
order, discharge summary, new admit order, new hospice service
Codebook assignment, new hospice specific attending provider, etc.) to signal
Definition Source: MTQIP the end of the patient’s stay, the hospital discharge date occurs
Data Base Column Name: DCDT when the acute phase of care ends. This does not include comfort
Type of Element: Date (MM/DD/YYYY Format) care status during the acute phase of care or transfer to medicine
Length: 8 services during the acute phase of care.
Report: #1
Resources
Codebook
Definition Source: MTQIP
Data Base Column Name: DCDT
Type of Element: Date (MM/DD/YYYY Format)
Length: 8
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