Performance Measurement Network

Question: Does a hold on anticoagulation count as a valid reason for not prescribing at discharge?

Physician documents in the discharge summary, "holding off on anticoagulation due to risk of hemorrhagic conversion". In addition, there is the following documentation by the physician during the hospital stay, "do not give anticoagulants increased bleeding". Would either or both documentation examples be sufficient reasons for not prescribing anticoagulation therapy at hospital discharge?

Answer:

Both documentation examples are valid reasons. A MD hold on an anticoagulant medication or discontinuation of the anticoagulant medication during the hospital stay constitutes a "clearly implied" reason for not prescribing at discharge.

A deferral of an anticoagulant does not count unless the problem underlying the deferral is also noted, as in your example.

i.e., "holding off on anticoagulation *due to risk of hemorrhagic conversion*", select 'Yes' for Reason for Not Prescribing Anticoagulation Therapy at Discharge. The problem/reason for not prescribing is documneted in the medical record.

i.e., "holding off on anticoagulation pending neurology consult", select 'No' for Reason for Not Prescribing Anticoagulation Therapy at Discharge.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK-03,
File:

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