Quality & Safety
Harm Measure Operational Definition Worksheet
Procedural Harm (Iatrogenic Pneumothorax on separate page)
Owner: CMO
Aim of Intervention(s): Reduce the occurrence of patients with procedure related harm
Definition: Rate per 1000 patient days of patients with coded occurrence of procedure related harm ICD9
codes.
Goal: Reduce the 2008 rate 25% by December 2009; 50% by December 2010
Baseline: Contains Iatrogenic Pneumothorax in procedure rate
12.22 HFH, 13.31 Macomb, 12.08 Warren, 7.92 Wyandotte
Benchmark: No estimate exists for the combined measure at this time since it is a broader measure than
any existing benchmark.
Potential Harm: Bleeding, anastigmatic leak, non-healing wound.
Associated Cost Info:
CALCULATION DETAILS:
Numerator Definition: Number of inpatients with ICD9 code between 998.0 -999.99 or beginning with E
not present on admission.
Numerator Inclusion(s)
Numerator Exclusion(s)
 All ICD9 codes between 998.0 – 999.99 or
beginning with E not present on admission
 None at this time
related to procedure. List of codes found to date
shown below. If a new code is found it is added.
Denominator Definition: Total patients discharged from an acute care stay.
Denominator Inclusion(s)
Denominator Exclusion(s)
All Acute care discharges.
References/Source: AHRQ Quality PSI Indicators Definition
Patient Days: All Acute Care patient days.
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Harm Measure Operational Definition Worksheet
ICD9 Diagnosis Codes included in Numerator. (Codes found to date)
998
998.11
998.12
998.13
998.2
998.31
998.32
998.4
998.51
998.59
998.6
998.81
998.83
998.89
999.2
E870.0
E870.5
E870.8
E870.9
E871.0
E872.6
E874.8
E876.8
E878.0
E878.1
E878.2
E878.3
E878.4
E878.5
E878.6
E878.8
E878.9
E879.0
E879.6
E879.8
E879.9
POSTOPERATIVE SHOCK, NOT ELSEWHERE CLASSIFIED
HEMORRHAGE COMPLICATING A PROCEDURE
HEMATOMA COMPLICATING A PROCEDURE
SEROMA COMPLICATING A PROCEDURE
ACCIDENTAL PUNCTURE OR LACERATION DURING A PROCEDURE, NOT ELSEWHERE
DISRUPTION OF INTERNAL OPERATION WOUND
DISRUPTION OF EXTERNAL OPERATION WOUND
FOREIGN BODY ACCIDENTALLY LEFT DURING A PROCEDURE, NOT ELSEWHERE CLA
INFECTED POSTOPERATIVE SEROMA
OTHER POSTOPERATIVE INFECTION
PERSISTENT POSTOPERATIVE FISTULA, NOT ELSEWHERE CLASSIFIED
EMPHYSEMA (SUBCUTANEOUS) RESULTING FROM PROCEDURE
NON-HEALING SURGICAL WOUND
OTHER SPECIFIED COMPLICATIONS OF PROCEDURES NOT ELSEWHERE CLASSIFIED
OTHER VASCULAR COMPLICATIONS OF MEDICAL CARE, NOT ELSEWHERE CLASSIFI
ACCIDENTAL CUT, PUNCTURE, PERFORATION OR HEMORRHAGE DURING SURGICAL
ACCIDENTAL CUT, PUNCTURE, PERFORATION OR HEMORRHAGE DURING ASPIRATIO
ACCIDENTAL CUT, PUNCTURE, PERFORATION OR HEMORRHAGE DURING OTHER SPE
ACCIDENTAL CUT, PUNCTURE, PERFORATION OR HEMORRHAGE DURING UNSPECIFI
FOREIGN OBJECT LEFT IN BODY DURING SURGICAL OPERATION
FAILURE OF STERILE PRECAUTIONS DURING HEART CATHETERIZATION
MECHANICAL FAILURE OF INSTRUMENT OR APPARATUS DURING OTHER SPECIFIED
OTHER SPECIFIED MISADVENTURES DURING MEDICAL CARE
SURGICAL OPERATION WITH TRANSPLANT OF WHOLE ORGAN CAUSING ABNORMAL P
SURGICAL OPERATION WITH IMPLANT OF ARTIFICIAL INTERNAL DEVICE CAUSIN
SURGICAL OPERATION WITH ANASTOMOSIS, BYPASS, OR GRAFT, WITH NATURAL
SURGICAL OPERATION WITH FORMATION OF EXTERNAL STOMA CAUSING ABNORMAL
OTHER RESTORATIVE SURGERY CAUSING ABNORMAL PATIENT REACTION, OR LATE
AMPUTATION OF LIMB(S) CAUSING ABNORMAL PATIENT REACTION, OR LATER CO
REMOVAL OF OTHER ORGAN (PARTIAL) (TOTAL) CAUSING ABNORMAL PATIENT RE
OTHER SPECIFIED SURGICAL OPERATIONS AND PROCEDURES CAUSING ABNORMAL
UNSPECIFIED SURGICAL OPERATIONS AND PROCEDURES CAUSING ABNORMAL PATI
CARDIAC CATHETERIZATION AS THE CAUSE OF ABNORMAL REACTION OF PATIENT
URINARY CATHETERIZATION AS THE CAUSE OF ABNORMAL REACTION OF PATIENT
OTHER SPECIFIED PROCEDURES AS THE CAUSE OF ABNORMAL REACTION OF PATI
UNSPECIFIED PROCEDURE AS THE CAUSE OF ABNORMAL REACTION OF PATIENT,
COLLECTION STRATEGY:
Sampling Strategy: None: a complete census of all coded acute care discharges will be used
Who is responsible for collecting the data?
Henry Ford Hospital
Helaine Moon
Macomb-Clinton Twp
Alan Kulawczyk
Macomb-Warren
Janine Waliszewski
Cottage
West Bloomfield
Glenn Victor
Wyandotte
Linda Meyers
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Harm Measure Operational Definition Worksheet
Maplegrove
NA
Kingswood
NA
Reported to Sharpoint File All Templates.xls by the 23rd day of every month
Author__Jack Jordan Date: _July 20, 2009______
Approval/Date: _______________________________________________________________________
RATIONALE/ISSUES/COMMENTS: (when and where addressed)
Provide rationale for inclusions or exclusions of data or criteria; include where and when the issue was
addressed/resolved
Date/Where Discussed
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Harm Measure Operational Definition Worksheet
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