The government is tracking Patient Safety Indicators (PSI) to assess quality of care. PSI 04 is a quality metric intended to measure the death rate among surgical patients with serious treatable
• PSI 04 is not included in the composite measure PSI 90 used for CMS value-based purchasing
• PSI 04 was removed from U.S. News & World Report methodology in 2019
• PSI 04 remains a component of the Leapfrog quality methodology
• Elective surgeries or any admission type with an operating room procedure within two days of admission
• Only “major operating room procedures” are included, as defined in the PSI 04 specifications by the MS-DRG and ICD-10 PCS codes
• Transfers to an acute care facility
• Patients enrolled in hospice care at admission
The measure includes death rates for the complications (strata) listed below, in order of priority from highest to lowest. In the event the case meets criteria for several strata, only one stratum is counted.
• Notable exclusions include any patient with a principal diagnosis of shock, cardiac arrest, trauma or hemorrhage
• Notable exclusions include any patient with a principal diagnosis code for sepsis or infection
• Notable exclusions include any ICD-10-CM code for viral pneumonia or influenza and any procedure code for lung cancer
• Notable exclusion is any patient with a principal diagnosis of DVT or PE
• Notable exclusions include any patient with a principal diagnosis of GI bleed, alcoholism or anemia
Download the complete tip, Patient Safety Indicator (PSI) 04.