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Release Notes:
Data Element
Version 2010A1

Data Element Name: Home Management Plan of Care Document Addresses Use of Relievers
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 the appropriate use of relievers. This information includes the medication name, dose, frequency, method of administration, and a stepwise method of adjusting the dose, based on severity of symptoms, in order to quickly relieve the symptoms of asthma exacerbation (asthma attack or asthma episodes).

Relievers are medications that relax the bands of muscle surrounding the airways. They are also known as rescue, quick-relief, or short acting medications of choice to quickly relieve asthma exacerbations brought about by bronchoconstriction and exercise-induced bronchospasm.

Relievers do not reduce inflammation of the airways in a person with asthma and are, therefore, not useful for long term control.

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, included written information on the appropriate use of relievers?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

Y    (Yes)   The HMPC document includes written information on the appropriate use of relievers.

N   (No)   The HMPC document does not include written information on the appropriate use of relievers or unable to determine from the 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.”
  • If reliever medications were prescribed, information must have been given on all of the following, in order to select “Yes” to this question:
    • medication name
    • dose
    • frequency
    • method of administration
    • stepwise method of adjusting the dose and/or frequency, based on severity of symptoms
  • “Reliever Not Specified (NOS)” can be used to answer “Yes” to this question in the following situations:
    • For new relievers that are not yet listed in Table 6.2
    • When there is documentation that a reliever was prescribed but unable to identify the name. It must be apparent that the medication is a reliever.
      Example:
      -On 2-12-08, the medical record contains the documentation, “Reliever prescribed name illegible, 2.5 ml, PO, BID.” (If “Reliever prescribed” had not been documented in this example, the medication could not be abstracted as Home Management Plan of Care Document Addresses Use of Relievers.
  • Documentation must clearly convey that the patient/ caregiver was given a copy of the HMPC document to take home.
  • The HMPC does NOT need to be given at the time of discharge. A HMPC document given at anytime during the hospital stay is acceptable.

Suggested Data Sources:

  • HPMC document
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • Refer to Appendix C, Table 6.2 for the comprehensive list of Reliever Medications.
  • None

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