Performance Measurement Network

Question: Is it considered CMO if the palliative care consult was done and the patient refuses palliative care the next day?

A palliative consult was done on a patient but the next day the family stated that they were not ready yet for comfort care. The palliative team continues to follow the patient during hospital stay. The patient improved slightly and was discharged to a LTC facility. Should we select CMO or would this scenario be considered "negative" documentation of CMO?

Answer:

Good question. Per the examples provided in the data element definition, the above documentation would not be considered negative, e.g., "On Day 1 the physician documents the patient is comfort measures only. On Day 2 the physician documents 'the patient is refusing CMO', select 1." The appropriate CMO value (1, 2, or 3) should be selected for this case, depending on when palliative care was first documented in the medical record.

The data element looks for the "earliest documentation" of Comfort Measures Only. If there is any documentation of CMO in the medical record, select the apppropriate value. However, if the only documentation of CMO is described as negative, e.g. "No CMO"; "Not a hospice candidate", then select value '4' "Not documented/UTD". See Alphabetical Data Element Dictionary definition for Comfort Measures Only, current version 3.2c.

http://www.jointcommission.org/specifications_manual_for_national_hospital_inpatient_quality_measures/

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical, Related Manual - Data Quality Manual
Related documents: STK, Comfort Measures Only-Stroke,
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