The Joint Commission’s 25 new ORYX measures
Acute Myocardial Infarction (AMI)
• Smoking Cessation Advice/Counseling — AMI patients with a history of smoking who are given smoking cessation advice or counseling during hospitalization.
• Aspirin at Arrival — AMI patients who are given aspirin within 24 hours of arrival or within 24 hours prior to arrival at the hospital.
• Reperfusion Therapy: Time from Arrival to Initiation — Timely reperfusion (opening blocked arteries) of eligible AMI patients; time from arrival to initiation of thrombolysis medication administration or primary percutaneous transluminal coronary angioplasty procedure.
• Aspirin at Discharge — AMI patients who are prescribed aspirin at discharge from the hospital.
• Beta Blocker at Arrival — AMI patients who receive beta blocker medication within the first 24 hours of arrival to the hospital.
• LVEF < 40% Prescribed ACEI at Discharge — AMI patients with low left ventricular ejection fraction (LVEF, an index of how well the heart functions) who are prescribed an angiotensin-converting enzyme inhibitor (ACEI) medication at discharge from the hospital.
• Beta Blocker at Discharge — AMI patients who are ideal candidates for beta blocker medication who are given a prescription for beta blockers at discharge.
• Intrahospital Mortality — Patients with a primary diagnosis of AMI who expire during hospitalization.
Heart Failure
• Patients with Atrial Fibrillation Prescribed Warfarin at Discharge — Heart failure patients with atrial fibrillation (irregular heartbeat) who are given a prescription for oral anticoagulation therapy (warfarin) at discharge from the hospital.
• Diet/Weight/Medication Management Instructions at Discharge — Heart failure patients who receive patient education (as documented on their written discharge instructions) regarding all of the following: all discharge medications, weight monitoring, diet, activity level, follow-up appointment, what to do if symptoms worsen.
• Assessment of Left Ventricular Function — Heart failure patients not admitted on ACEIs or angiotensin receptor blocking (ARB) agent medications who have LVEF evaluated before or during admission.
• LVEF < 40% Prescribed ACEI at Discharge — Patients with low LVEF who are prescribed an ACEI medication at discharge.
• Smoking Cessation Advice/Counseling — Heart failure patients with a history of smoking who are given smoking cessation advice or counseling during hospitalization.
Community-Acquired Pneumonia
• Pneumonia Screen or Pneumococcal Vaccination — Patients age 65 or older who are screened for or given pneumococcal vaccination during hospitalization.
• Smoking Cessation Advice/Counseling — Pneumonia patients with a history of smoking who are given smoking cessation advice or counseling during hospitalization, or advice or counseling is given to pediatric caregiver about effects of second-hand smoke.
• Oxygenation Assessment — Patients who receive oxygenation assessment (determine amount of oxygen in blood) within 24 hours of hospital arrival.
• Blood Cultures — Of patients who have blood cultures collected, those who have them drawn prior to first dose of antibiotic administration in the hospital.
• Antibiotic Timing — Time in hours from initial presentation at hospital to first dose of antibiotics.
• Empiric Antibiotic Regimen Non-ICU — For pneumonia patients not admitted to an ICU, the antibiotic given is consistent with current consensus guidelines (e.g., the American Thoracic Society, Infectious Disease Society of America, and the Centers for Disease Control and Prevention).
• Empiric Antibiotic Regimen ICU — For pneumonia patients admitted to an ICU, the antibiotic given is consistent with current consensus guidelines (e.g., the American Thoracic Society, Infectious Disease Society of America, and the Centers for Disease Control and Prevention).
Surgical Procedures and Complications
• Surgical Site Infection Within 30 Days (for selected surgical procedures) — Patients undergoing selected surgical procedures who develop a surgical site infection within 30 days of the procedure.
• Timing of Prophylactic Administration of Antibiotic — Timing of when patients were given prophylactic intravenous antibiotic administration for selected surgical procedures.
Pregnancy and Related Conditions
• VBAC Rate — Patients who have had a cesarean section who have a vaginal delivery.
• Third- or Fourth-Degree Laceration — Patients who have vaginal deliveries with third- or fourth-degree laceration.
• Neonatal Mortality — Infants who expire within 28 days of birth.
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