Measure Title: Adherence to Blood Conservation Guidelines for Cardiac Operations using Cardiopulmonary Bypass (CPB) – Composite
Measure Description: Percentage of Patients with age 18 years and older, who undergo a cardiac operation using cardiopulmonary bypass for whom selected blood conservation strategies were used.
Denominator: Patients, 18 years or older, who undergo a cardiac operation using cardiopulmonary bypass.
Numerator: Patients for whom selected blood conservation strategies were used.
Numerator Scoring:
Each blood conservation strategy of this measure accounts for 25% of the total composite score. Each of the four blood conservation strategies must be reported to be included in the performance measurement. The total composite score will be calculated by the data source and not the individual practitioner.
1. Use of Lysine analogues· Numerator Note: As indicated by Intraoperative Antifibrinolytic med: Aminocaproic Acid or Tranexamic Acid.2. Use of mini-circuits or Retrograde Autologous Priming (RAP) or Ultrafiltration (Minimize hemodilution caused by cardiopulmonary bypass pump priming solution)· Numerator Note: Record the usage of retrograde autologous priming or a miniaturized circuit volume by the cardiopulmonary perfusion team prior to the onset of cardiopulmonary bypass.· Numerator Note: Capture the total volume of ultra filtrate removed by the cardiopulmonary perfusion team during cardiopulmonary bypass and during modified ultra-hemofiltration post-CPB. Record the data in milliliters.3. Use of red cell salvage using centrifugation· Numerator Note: Capture the volume of cell saver collected and given. Do not include autologous, allogeneic, pump-residual, or chest-tube recirculated blood.4. Use of transfusion algorithm supplemented with point-of-care testing· Numerator Note: Transfusion algorithm includes SCA/STS guideline recommendations or an evidence-based algorithm formulated at the local level.
Numerator Note: Capture the total volume of ultra filtrate removed by the cardiopulmonary perfusion team during cardiopulmonary bypass and during modified ultra-hemofiltration post-CPB. Record the data in milliliters.3. Use of red cell salvage using centrifugation ·
Numerator Note: Capture the volume of cell saver collected and given. Do not include autologous, allogeneic, pump-residual, or chest-tube recirculated blood. 4. Use of transfusion algorithm supplemented with point-of-care testing· Numerator Note: Transfusion algorithm includes SCA/STS guideline recommendations or an evidence-based algorithm formulated at the local level
Denominator Exclusions: Emergent cases, Lung transplants not using cardiopulmonary bypass. Procedure reduced or discontinued prior to initiation of CPB as indicated on the claim by Modifier 52 or Modifier 53.
Denominator Exceptions: NoneNQF ID Number: N/A
NQS Domain: Efficiency and Cost Reduction
High Priority Measure: No
Measure Type: Process
Includes Teleheatlh: No
Inverse Measure: No
Proportional Measure: Yes
Continuous Variable Measure: No
Ratio Measure: No
Number of performance rates to be calculated and submitted: 1
Risk-Adjusted Status: No
Care Setting: Hospital Inpatient
Submission Pathway: Traditional MIP