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

Generated Narrative: Measure

Enables specification of proposed measure reporting: Once per 1 days

wg: pher

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: 2024-01-25 13:42:59+0000

publisher: HL7 International / Public Health

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

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

UseContexts

jurisdiction: World (m49.htm#001)

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

relatedArtifact

type: documentation

label: NHSN COVID-19 Reporting

display: CDC/NHSN COVID-19 Patient Impact & Hospital Capacity Module Home Page

url: https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/acute-care-hospital/covid19/

document

relatedArtifact

type: documentation

label: How to import COVID-19 Summary Data

display: Importing COVID-19 Patient Module Denominator data for Patient Safety Component

url: https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/import-covid19-data-508.pdf

document

relatedArtifact

type: documentation

label: Table of Instructions

display: Instructions for Completion of the COVID-19 Patient Impact and Hospital Capacity Module Form (CDC 57.130)

url: https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/57.130-toi-508.pdf

document

relatedArtifact

type: documentation

label: CSV File Template

display: CDC/NHSN COVID-19 Reporting CSV File Template

url: https://web.archive.org/web/20200501215043/https://www.cdc.gov/nhsn/pdfs/covid19/covid19-test-csv-import.csv

document

library: NHSN Patient Impact and Hospital Capacity Measure Library

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

url

scoring

value: Continuous Variable (MeasureScoring#continuous-variable)

url

subject

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

url

type

value: Structure (MeasureType#structure)

url

improvementNotation

value: Increased score indicates improvement (MeasureImprovementNotation#increase)

url

rateAggregation

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.

Criteria

-	Description	Name	Language	Expression
*	A bed in any location	numTotBeds	text/fhirpath	Device.where(type in %ValueSet-BedDeviceTypes and location.physicalType in %ValueSet-BedLocationTypes)

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.

Criteria

-	Description	Name	Language	Expression
*	A Bed where the location is an inpatient location.	numbeds	text/fhirpath	%numTotBeds.where(location.type in %ValueSet-InpatientLocations)

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.

Criteria

-	Description	Name	Language	Expression
*	An Inpatient Bed where the Bed is occupied.	numBedsOcc	text/fhirpath	%numbeds.where(location.operationalStatus = %ValueSet-OccupiedBed)

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

Criteria

-	Description	Name	Language	Expression
*	A Bed where the location is an inpatient ICU location.	numICUBeds	text/fhirpath	%numbeds.where(location.type in %ValueSet-ICULocations)

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

Criteria

-	Description	Name	Language	Expression
*	An ICU Bed that is occupied.	numICUBedsOcc	text/fhirpath	%numICUBeds.where(location.operationalStatus = %ValueSet-OccupiedBed)

group

Attributes describing a group of measures

url

scoring

value: Continuous Variable (MeasureScoring#continuous-variable)

url

subject

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

url

type

value: Structure (MeasureType#structure)

url

improvementNotation

value: Decreased score indicates improvement (MeasureImprovementNotation#decrease)

url

rateAggregation

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.

Criteria

-	Description	Name	Language	Expression
*	A Device that is used for ventilation and could be used (e.g., not broken, transferred, etc)	numVent	text/fhirpath	Device.where(type in %ValueSet-VentilatorDevices and status = active)

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.

Criteria

-	Description	Name	Language	Expression
*	A ventilator that is attached to a patient.	numVentUse	text/fhirpath	%numVent.where(patient!={})

group

Attributes describing a group of measures

url

scoring

value: Continuous Variable (MeasureScoring#continuous-variable)

url

subject

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

url

type

value: Structure (MeasureType#structure)

url

improvementNotation

value: Decreased score indicates improvement (MeasureImprovementNotation#decrease)

url

rateAggregation

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).

Criteria

-	Description	Name	Language	Expression
*	An COVID-19 encounter where the active location is an inpatient location	numC19HospPats	text/fhirpath	%numC19Pats.where(location.where(status='active' and type in %ValueSet-InpatientLocations))

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.

Criteria

-	Description	Name	Language	Expression
*	An COVID-19 encounter in an inpatient setting on a ventilator	numC19OFMechVentPats	text/fhirpath	%numC19HospPats.intersect(%numC19VentPats)

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.

Criteria

-	Description	Name	Language	Expression
*	Encounters associated with suspected or confirmed COVID-19 with onset > 14 days after start	numC19HOPats	text/fhirpath	Condition.where( code in %ValueSet-SuspectedOrDiagnosedCOVID19 and encounter in %numC19HospPats and onset + 14 days > encounter.period.start).encounter

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.

Criteria

-	Description	Name	Language	Expression
*	An COVID-19 encounter where the active location is an ED or Overflow location	numC19OverflowPats	text/fhirpath	%numC19Pats.where(location.where(status='active' and type in %ValueSet-EDorOverflowLocations))

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.

Criteria

-	Description	Name	Language	Expression
*	An COVID-19 encounter where the active location is an ED or Overflow location	numC19OFMechVentPats	text/fhirpath	%numC19OverflowPats.intersect(%numC19VentPats)

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.

Criteria

-	Description	Name	Language	Expression
*	All C19 Patients who have died in an encounter during the reporting period.	numC19Died	text/fhirpath	%numC19Pats.hospitalization.dispostion in %ValueSet-PatientDied

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).

Criteria

-	Description	Name	Language	Expression
*	Active encounters where the encounter diagnosis is suspected or confirmed COVID-19, or a Condition of suspected or confirmed COVID-19 was created during that encounter.	numC19Pats	text/fhirpath	Encounter.where(clinicalStatus = 'active' and diagnosis.condition.ofType(Condition).code in %ValueSet-SuspectedOrDiagnosedCOVID19) | Encounter.where(clinicalStatus = "active" and Condition.where(code in %ValueSet-SuspectedOrDiagnosedCOVID19).encounter = $this)

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.

Criteria

-	Description	Name	Language	Expression
*	A COVID-19 encounter where the patient is ventilated	numC19VentPats	text/fhirpath	%numC19Pats.where(Device.where(type in %ValueSet-VentilatorDevices and status = active).patient = $this.patient)