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PSI-17 Birth Trauma – Injury to the Neonate

PSI-17 Birth Trauma – Injury to the Neonate. OB Adverse Event Affinity Call Lynne Hall 7/23/14. Framing. What is an injury to the neonate? Specifications of the PSI-17 Numerator/Denominator What can be done? Graph Questions. Injury to the neonate.

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PSI-17 Birth Trauma – Injury to the Neonate

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  1. PSI-17 Birth Trauma – Injury to the Neonate OB Adverse Event Affinity Call Lynne Hall 7/23/14

  2. Framing • What is an injury to the neonate? • Specifications of the PSI-17 • Numerator/Denominator • What can be done? • Graph • Questions

  3. Injury to the neonate Birth injury is defined as an impairment of the neonate's body function or structure due to an adverse event that occurred at birth. Birth injury ranges from mild (bruising) to severe (death)

  4. Injury to the Neonate Risk Factors Macrosomia Maternal Obesity Abnormal Fetal Presentation Operative vaginal delivery Cesarean Delivery

  5. PSI-17 Numerator: To include only these codes:

  6. PSI-17 • Denominator: • Exclusions: • Preterm infants with a birth weight less than 2000 grams • Infants with any diagnosis code of injury to the brachial plexus • Infants with any diagnosis code of osteogenesisimperfecta • Cases with missing gender, age, quarter, year, or principal diagnosis • www.qualityindicators.ahrq.gov specifications manual

  7. PSI-17 What is NOT a birth trauma Petechiae Mongolian Spots Hemangiomas Port-wine Nevi What else?

  8. Neonatal Injury In CY2013 there were 152 incidents of Neonatal Injury Ranges include 0 incidents to 28 incidents Please email me if you would like your hospitals number of incidents: lhall@gha.org

  9. What can be done? • Review all cases that have been given the diagnosis of Neonatal Injury • Educate coders on what constitutes a birth injury • Example: Infant has petechiae (not a birth injury) – this gets coded as 767.8 Other birth injury • Encourage physicians to document clearly birth injuries • Example: instead of charting Mongolian spots chart normal finding of Mongolian spots

  10. PSI-17

  11. Sharing Has anyone reviewed cases and found errors? What do you think can be done to lower the rate?

  12. Questions? Next meeting: August 27th 11:00-11:30 No meeting in September

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