Situational Awareness for Novel Epidemic Response
1.0.1 - STU Release

Situational Awareness for Novel Epidemic Response, published by HL7 International Public Health Workgroup. This is not an authorized publication; it is the continuous build for version 1.0.1). This version is based on the current content of https://github.com/HL7/fhir-saner/ and changes regularly. See the Directory of published versions

Example Measure: CDC Patient Impact and Hospital Capacity

This measure demonstrates reporting on bed availability and use at a facility location based on CDC/NHSN reporting requirements.

Related artifacts

  • CDC/NHSN COVID-19 Acute Care Module Home Page
  • Facility - How to Upload COVID-19 CSV Data Files
  • NHSN COVID-19 Module Analysis Reports
  • Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Pathway (CDC 57.130)
  • Patient Impact and Hospital Capacity Pathway Form
  • CDC/NHSN COVID-19 Acute Care Patient Impact Reporting CSV File Template
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    Definitions

    Ventilator
    Any device used to support, assist or control respiration (inclusive of the weaning period) through the application of positive pressure to the airway when delivered via an artificial airway, specifically an oral/nasal endotracheal or tracheostomy tube. Note: Ventilation and lung expansion devices that deliver positive pressure to the airway (for example: CPAP, BiPAP, bi-level, IPPB and PEEP) via non-invasive means (for example: nasal prongs, nasal mask, full face mask, total mask, etc.) are not considered ventilators unless positive pressure is delivered via an artificial airway (oral/nasal endotracheal or tracheostomy tube).
    Beds
    Baby beds in mom's room count as 1 bed, even if there are multiple baby beds Follow-up in progress if staffed is less than licensed. Total includes all beds, even if with surge beds it exceeds licensed beds.
    ICU beds
    Include NICU (from CDC Webinar 31-Mar-2020) (outstanding question on burn unit)

    Group Definitions

    Group SystemGroup CodePopulation SystemPopulation Code
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystemBeds
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues
    http://terminology.hl7.org/CodeSystem/measure-population
    numTotBeds
    initial-population
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumBeds
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumBedsOcc
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumICUBeds
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumICUBedsOcc
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystemVentilators
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValues
    http://terminology.hl7.org/CodeSystem/measure-population
    numVent
    initial-population
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumVentUse
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasureGroupSystemEncounters
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumC19HospPats
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumC19MechVentPats
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumC19HOPats
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumC19OverflowPats
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumC19OFMechVentPats
    http://hl7.org/fhir/uv/saner/CodeSystem/MeasuredValuesnumC19Died

Generated Narrative

Resource "CDCPatientImpactAndHospitalCapacity"

Profile: Public Health Measure

Enables specification of proposed measure reporting: Do Once per 1 days

url: http://hl7.org/fhir/uv/saner/Measure/CDCPatientImpactAndHospitalCapacity

version: 1.0.1

name: CDCPatientImpactAndHospitalCapacity

title: Patient Impact and Hospital Capacity

status: draft

experimental: true

date: 2021-12-07T20:30:08Z

publisher: HL7 International Public Health Workgroup

contact: http://hl7.org/Special/committees/pher, pher@lists.hl7.org, Keith W. Boone: mailto:kboone@ainq.com

jurisdiction: World (m49.htm#001)

author: Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN): mailto:nhsn@cdc.gov

library: http://hl7.org/fhir/uv/saner/StructureDefinition/NHSNMeasureLibrary

definition: Ventilator : Any device used to support, assist or control respiration (inclusive of the weaning period) through the application of positive pressure to the airway when delivered via an artificial airway, specifically an oral/nasal endotracheal or tracheostomy tube. Note: Ventilation and lung expansion devices that deliver positive pressure to the airway (for example: CPAP, BiPAP, bi-level, IPPB and PEEP) via non-invasive means (for example: nasal prongs, nasal mask, full face mask, total mask, etc.) are not considered ventilators unless positive pressure is delivered via an artificial airway (oral/nasal endotracheal or tracheostomy tube). Beds : Baby beds in mom's room count as 1 bed, even if there are multiple baby beds Follow-up in progress if staffed is less than licensed. Total includes all beds, even if with surge beds it exceeds licensed beds. ICU beds : Include NICU (from CDC Webinar 31-Mar-2020) (outstanding question on burn unit)

group

Attributes describing a group of measures

value: Continuous Variable (MeasureScoring#continuous-variable)

value: Hospital Beds (ResourceType#Location; SNOMED CT#91537007 "Hospital bed, device (physical object)")

value: Structure (MeasureType#structure)

value: Increased score indicates improvement (MeasureImprovementNotation#increase)

value: count

code: Hospital Bed Reporting (Measure Group System#Beds "Beds")

population

code: Total number of all Inpatient and outpatient beds, including all staffed,ICU, licensed, and overflow (surge) beds used for inpatients or outpatients (Measured Values in Sample Measures#numTotBeds "All Hospital Beds"; MeasurePopulationType#initial-population)

description: Enter the total number of all hospital beds, including inpatient and outpatient beds. All staffed, licensed, and overflow and surge/expansion beds used for inpatients or outpatients. This includes ICU beds.

population

code: Inpatient beds, including all staffed, licensed, and overflow (surge) beds used for inpatients (Measured Values in Sample Measures#numbeds "Hospital Inpatient Beds")

description: Required. Enter the total number of all inpatient beds, including all staffed, licensed, and overflow and surge/expansion beds created for inpatient care. This includes intensive care unit (ICU) beds.

population

code: Total number of staffed inpatient beds that are occupied (Measured Values in Sample Measures#numBedsOcc "Hospital Inpatient Bed Occupancy")

description: Enter the total number of staffed inpatient beds occupied by patients at the time the data is collected, including all staffed, licensed, and overflow and surge/expansion beds created for inpatient care. This includes ICU beds. CDC Webinar 31-Mar-2020: Baby beds in mom's room count as 1 bed, even if there are multiple baby beds Follow-up in progress if staffed is less than licensed. Total includes all beds, even if with surge beds it exceeds licensed beds.

population

code: ICU Bed Occupancy (Measured Values in Sample Measures#numICUBeds "ICU Beds")

description: Enter the total number of staffed Intensive Care Unit (ICU) beds. CDC Webinar 31-Mar-2020: ICU beds include NICU

population

code: Total number of staffed inpatient intensive care unit (ICU) beds (Measured Values in Sample Measures#numICUBedsOcc "ICU Bed Occupancy")

description: Enter the total number of staffed ICU beds occupied by patients at the time the data is collected. CDC Webinar 31-Mar-2020: ICU beds include NICU

group

Attributes describing a group of measures

value: Continuous Variable (MeasureScoring#continuous-variable)

value: Ventilator (ResourceType#Device; SNOMED CT#706172005 "Ventilator (physical object)")

value: Structure (MeasureType#structure)

value: Decreased score indicates improvement (MeasureImprovementNotation#decrease)

value: count

code: Hospital Ventilators Reporting (Measure Group System#Ventilators "Ventilators")

population

code: Total number of ventilators available (Measured Values in Sample Measures#numVent "Mechanical Ventilators"; MeasurePopulationType#initial-population)

description: Enter the total number of mechanical ventilators, including anesthesia machines and portable/transport ventilators available in the facility. Include BiPAP machines if the hospital uses BiPAP to deliver positive pressure ventilation via artificial airways.

population

code: Total number of ventilators in use (Measured Values in Sample Measures#numVentUse "Mechanical Ventilators in Use")

description: Enter the total number of mechanical ventilators use at the time the data is collected, including anesthesia machines and portable/transport ventilators. Include BiPAP machines if the hospital uses BiPAP to deliver positive pressure ventilation via artificial airways.

group

Attributes describing a group of measures

value: Continuous Variable (MeasureScoring#continuous-variable)

value: Encounter (ResourceType#Encounter; SNOMED CT#308335008 "Patient encounter procedure (procedure)")

value: Structure (MeasureType#structure)

value: Decreased score indicates improvement (MeasureImprovementNotation#decrease)

value: count

code: Hospital COVID-19 Encounters Reporting (Measure Group System#Encounters "Encounters")

population

code: Patients currently hospitalized in an inpatient care location who have suspected or confirmed COVID-19 (Measured Values in Sample Measures#numC19HospPats "Hospitalized COVID-19 Patients")

description: Enter the number of patients hospitalized in an inpatient bed at the time the data is collected who have suspected or confirmed COVID-19. This includes the patients with laboratory-confirmed or clinically diagnosed COVID-19. Confirmed: A patient with a laboratory confirmed COVID-19 diagnosis Suspected: A patient without a laboratory confirmed COVID-19 diagnosis who, in accordance with CDC’s Interim Public Health Guidance for Evaluating Persons Under Investigation (PUIs), has signs and symptoms compatible with COVID-19 (most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness, such as cough, shortness of breath or myalgia/fatigue).

population

code: Patients currently hospitalized in an inpatient bed who have suspected or confirmed COVID-19 and are on a mechanical ventilator (Measured Values in Sample Measures#numC19MechVentPats "Hospitalized and Ventilated COVID-19 Patients")

description: Enter the number of patients hospitalized in an inpatient bed who have suspected or confirmed COVID-19 and are currently on a mechanical ventilator* at the time the data is collected . This includes the patients with laboratory-confirmed or clinically diagnosed COVID-19.

population

code: Patients currently hospitalized in an inpatient bed with onset of suspected or confirmed COVID-19 fourteen or more days after hospital admission due to a condition other than COVID-19 (Measured Values in Sample Measures#numC19HOPats "Hospital Onset COVID-19 Patients")

description: Enter the number of patients hospitalized in an inpatient bed at the time the data is collected with onset of suspected or confirmed COVID-19 fourteen or more days after hospitalization (admission date = hospital day 1). This includes laboratory-confirmed or clinically diagnosed COVID-19 cases.

population

code: Patients with suspected or confirmed COVID-19 who are currently in the Emergency Department (ED) or any overflow location awaiting an inpatient bed (Measured Values in Sample Measures#numC19OverflowPats "ED/Overflow COVID-19 Patients")

description: Enter the number of patients with suspected or confirmed COVID-19 who are in the Emergency Department(ED) or any overflow/expansion location awaiting placement in an inpatient bed at the time the data is collected . This includes patients with laboratory-confirmed or clinically diagnosed COVID-19. Overflow locations include any physical locations created to accommodate patients include but not limited to 24-hour observation units, hallways, parking lots, or tents.

population

code: Patients with suspected or confirmed COVID-19 who currently are in the ED or any overflow location awaiting an inpatient bed and on a mechanical ventilator (Measured Values in Sample Measures#numC19OFMechVentPats "ED/Overflow and Ventilated COVID-19 Patients")

description: Enter the number of patients with suspected or confirmed COVID-19 who are in the ED or any overflow/expansion location on a mechanical ventilator* at the time the data is collected . This includes patients with laboratory-confirmed or clinically diagnosed COVID-19.

population

code: Patients with suspected or confirmed COVID-19 who died in the hospital, ED or any overflow location on the date for which you are reporting. (Measured Values in Sample Measures#numC19Died "COVID-19 Patient Deaths")

description: Enter the number of patients with suspected or confirmed COVID-19 who died in the hospital, ED, or any overflow location. This includes patients with laboratory-confirmed or clinically diagnosed COVID-19. Please enter the count of deaths newly occurred, at the time the data is collected instead of the cumulated number of deaths.

population

code: Patients with suspected or confirmed COVID-19 in any location. (Measured Values in Sample Measures#numC19Pats "All COVID-19 Confirmed or Suspected Patients"; MeasurePopulationType#initial-population)

description: Enter the number of patients in any location at the time the data is collected who have suspected or confirmed COVID-19. This includes the patients with laboratory-confirmed or clinically diagnosed COVID-19. Confirmed: A patient with a laboratory confirmed COVID-19 diagnosis Suspected: A patient without a laboratory confirmed COVID-19 diagnosis who, in accordance with CDC’s Interim Public Health Guidance for Evaluating Persons Under Investigation (PUIs), has signs and symptoms compatible with COVID-19 (most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness, such as cough, shortness of breath or myalgia/fatigue).

population

code: Patients in any location who have suspected or confirmed COVID-19 and are currently on a ventilator. (Measured Values in Sample Measures#numC19VentPats "Ventilated COVID-19 Patients")

description: Enter the number of patients in any location who have suspected or confirmed COVID-19 and are currently on a mechanical ventilator* at the time the data is collected. This includes the patients with laboratory-confirmed or clinically diagnosed COVID-19.