2021 ECPR52: Appropriate Treatment of Psychosis and Agitation in the Emergency Department

Measure Description

Percentage of Adult Patients With Psychosis or Agitation Who Were Ordered an Oral Antipsychotic Medication in the Emergency Department

Denominator

• Any patient ≥ 18 years of age evaluated by the Eligible Professional in the Emergency Department (99281-99285 & 99291-99292 AND Place of Service Indicator: 23) PLUS
• Emergency department length of stay of 4 hours or more PLUS
• Diagnosis of psychosis, psychotic disorder NOS, psychotic features, hallucinations, schizophrenia, schizoaffective disorder, agitation due to psychosis
  • ICD10: F06.0, F06.2, F20.0, F20.1, F20.2, F20.3, F20.5, F20.81, F20.89, F20.9, F21, F23, F24, F25.0, F25.1, F25.8, F25.9, F30.2, F31.2, F31.5, F31.64, F32.3, F33.3 F53.1
• Eloped or AMA patients are excluded (V0700)

Numerator

Patients who were ordered at least one oral dose of a typical or atypical antipsychotic or an antipsychotic combination medication

Definition (Qualifying Medications):

• First Generation Antipsychotics
  • Chlorpromazine
  • Fluphenazine
  • Haloperidol
  • Loxapine
  • Molindone
  • Perphenazine
  • Pimozide
  • Prochlorperazine
  • Thioridazine
  • Thiothixene
  • Trifluoperazine
• Second Generation Antipsychotics
  • Aripiprazole
  • Asenapine
  • Clozapine
  • Olanzapine
  • Iloperidone
  • Lurasidone
  • Paliperidone
  • Quetiapine
  • Risperidone
  • Ziprasidone
• Combination Antipsychotics
  • Olanzapine-Fluoxetine
  • Perphenazine-Amitriptyline

Numerator Options:

• Performance Met (VE272): Oral dose of a typical or atypical antipsychotic or an antipsychotic combination medication prescribed
• Medical Performance Exclusion (Denominator Exception) (VE273): Oral dose of a typical or atypical antipsychotic or an antipsychotic combination medication not prescribed for medical reason documented by the eligible professional (e.g., patient refusal, inability to tolerate, allergy, intramuscular/intravenous route chosen due to aggressive behavior, or other documented medical reason)
• Performance Not Met (VE274): Oral dose of a typical or atypical antipsychotic or an antipsychotic combination medication not prescribed, reason not specified

Numerator Exclusions

None

NQF ID Number

N/A

NQS Domain

Effective Clinical Care

High Priority Measure

No

Includes Telehealth?

Yes

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