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Release Notes:
Data Element
Version 2010A1

Data Element Name: First PCI Time
Collected For: AMI-8, AMI-8a,
Definition:The first time the lesion was accessed during the first PCI. PCI is defined as the dilation of a coronary (heart) arterial obstruction by means of a balloon catheter inserted into a narrowed blood vessel and inflated, to flatten plaque against the artery wall. This may be performed with or without a stent, a metal scaffold that is used to assist in establishing and maintaining vessel patency.
Suggested Data Collection Question:What was the time of the first percutaneous coronary intervention (PCI) done after hospital arrival?
Format:
Length:5 - HH:MM (with or without colon) or UTD
Type:Time
Occurs:1
Allowable Values:


HH = Hour (00-23)
MM = Minutes (00-59)
UTD = Unable to Determine

Time must be recorded in military time format.
With the exception of Midnight and Noon:

  • If the time is in the a.m., conversion is not required
  • If the time is in the p.m., add 12 to the clock time hour

Examples:
Midnight - 00:00      Noon - 12:00
5:31 am - 05:31     5:31 pm - 17:31
11:59 am - 11:59    11:59 pm - 23:59

Note:
00:00 – midnight. If your electronic system documents time as 00:00 11-24-2007, review supporting documentation to determine if the First PCI Date should remain 11-24-2007 or if it should be converted to 11-25-2007. When converting 24:00 to 00:00 do not forget to change the First PCI Date.
Example:
Midnight or 24:00 on 11-24-2007 = 00:00 on 11-25-2007

Notes for Abstraction:
  • For times that include “seconds”, remove the seconds and record the time as is.
    Example:
    15:00:35 would be recorded as 15:00
  • If the PCI time is unable to be determined from medical record documentation, select “UTD.”
  • The medical record must be abstracted as documented (taken at “face value”). When the time documented is obviously in error (not a valid format/range) and no other documentation is found that provides this information, the abstractor should select “UTD.”
    Example:
    Documentation indicates the First PCI Time was 3300. No other documentation in the medical record provides a valid time. Since the First PCI Time is outside of the range listed in the Allowable Values for “Hour,” it is not a valid time and the abstractor should select “UTD.”
    Note:
    Transmission of a case with an invalid time as described above will be rejected from the QIO Clinical Warehouse and the Joint Commission’s Data Warehouse. Use of “UTD” for First PCI Time allows the case to be accepted into the warehouse.
  • Do NOT include PCIs which were attempted but not completed on at least one vessel - e.g., angioplasty device (balloon, stent, thrombectomy device) could not be delivered to the blocked area of the artery, balloon could not be inflated, guidewire could not be advanced. Include PCIs that are completed but unsuccessful in maintaining the flow of blood through the artery. These may be described as “failed completed.”
  • Use the earliest time from the following allowable times:
    1. Time of the first balloon inflation (Inflate #1, Balloon inflated, # ATM for # minutes/seconds, Time balloon deployed). If, however, there is documentation of a time associated with a balloon but not of a specific time that the balloon was inflated or deployed (e.g., “11:35 Voyager balloon” only), infer this to be the time of use, unless documentation suggests otherwise.
    2. Time of the first stent deployment (Time stent deployed, Time stent placed, Time stent inserted, Time stent expanded). If, however, there is documentation of a time associated with a stent but not of a specific time that the stent was deployed, placed, etc. (e.g., “11:35 Cypher stent” only), infer this to be the time deployed, placed, etc., unless documentation suggests otherwise.
    3. Time of the first treatment of lesion with another device (Time Angiojet or other thrombectomy device used, Time of aspiration, Time of suction, Time of device pass, Excimer time, Laser time, Time Rotablator used). If, however, there is documentation of a time associated with a device but not of a specific time that the device was used (e.g., “11:35 Angiojet” only), infer this to be the time of use, unless documentation suggests otherwise.
  • The earliest time from the above allowable times should be used regardless of how many vessels were treated or which ones were successful vs. unsuccessful.
  • Use the above allowable times regardless of the time of documentation of coronary blood flow (e.g., TIMI-3 flow, reperfusion).
  • Disregard documentation on the procedure sheet of “lesion” accompanied solely by a time (e.g., “08:52 – RCA lesion”). Do NOT make the inference that this reflects lesion treatment time.
Suggested Data Sources:
  • Diagnostic test reports
  • Operative notes
  • Procedure notes
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • None
  • None

First PCI Time
Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)