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Release Notes:
Data Element
Version 2010A1

Data Element Name: Home Management Plan of Care Document Addresses Environmental Control and Control of Other Triggers
Collected For: CAC-3, Joint Commission Only , Test Measure
Definition:Documentation exists that the Home Management Plan of Care (HMPC) document, separate and specific to the patient and provided to the patient/caregiver, prior to or upon discharge, includes written information on avoidance or mitigation of environmental and other triggers.
Suggested Data Collection Question:Does the HMPC document, separate and specific to the patient and provided to the patient/caregiver, prior to or upon discharge, include written information on avoidance or mitigation of environmental and other triggers?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

Y    (Yes)   The HMPC document includes written information on avoidance or mitigation of environmental and other triggers.

N   (No)   The HMPC document does not include written information on avoidance or mitigation of environmental and other triggers or unable to determine from medical record documentation.

Notes for Abstraction:
  • Specificity to the patient entails explicit information pertaining to the patient, i.e., the patient’s specific controllers and relievers medication information (name, dose, frequency, and method of administration), environmental control and control of other triggers, and methods and timing of rescue actions specific to the patient, in order to select “Yes.”
  • HMPC must be a separate, stand alone document, in order to select “Yes.”
  • Triggers are things in the environment or life circumstances that could lead to asthma attacks. Triggers could be allergens or irritants. Environmental triggers could be found indoors or outdoors. Indoor locations could be homes, schools, workplace, churches, concert halls, etc.
    Examples of environmental triggers:
    • Animal dander (from the skin, hair, or feathers of animals)
    • Dust mites (contained in house dust)
    • Cockroaches
    • Pollen from tree and grass
    • Mold (indoor and outdoor)
    • Cigarette or tobacco smoke
    • Air pollutants (dust, house hold cleaners, hair sprays, other chemicals)
    • Cold air or changes in weather
    • Strong emotional expression (including crying or laughing hard)
    • Stress
      Other triggers may include:
    • Medications such as aspirin and beta-blockers
    • Sulfites in food (dried fruit) or beverages (wine)
    • Infections and inflammatory conditions (i.e., flu, cold, rhinitis)
    • Gastroesophageal reflux disease that causes heartburn and can worsen asthma symptoms, especially at night
    • Emotional stress
    • Exercise or strenuous activity

  • Documentation must clearly convey that the patient was given a copy of the HMPC to take home.
  • The HMPC does NOT need to be given at the time of discharge. A home management plan of care given at anytime during the hospital stay is acceptable.
  • If there is documentation of Triggers (environment or others), select “Yes.”
Suggested Data Sources:

  • HMPC document
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • None
  • None

Home Management Plan of Care Document Addresses Environmental Control and Control of Other Triggers
Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)