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Some additional changes to coding updates that are reflected in the v2018 software include:

• The Pediatric Quality Indicator NQI 02 (Neonatal Mortality Rate) is suppressed (see Question 9 for more information).
• The ABDOMIOPEN, ABDOMIPOTHER, and ABDOMI15P formats/setnames were updated to remove esophageal and other esophageal insertion procedures unlikely to be approached through the abdomen. The specifications for PSI 14 and PDI 11 (Postoperative Wound Dehiscence Rate), respectively for the adult and pediatric populations, and PSI 15 (Unrecognized Abdominopelvic Accidental Puncture or Laceration Rate) limit the denominator to abdominopelvic surgery discharges only.
• The formats/setnames used in PDI 08 and PSI 09 (Perioperative Hemorrhage or Hematoma Rate) for pediatric and adult discharges were updated to better match the technical specifications. This includes removing ICD-10 PCS procedure codes in the HEMOTH2P format/setname for control of perioperative hemorrhage and evacuation of hematoma procedures for excision or drainage unrelated to hemorrhage or hematoma. The NEUROMD format identifying neuromuscular disorders updated diagnosis codes to specify respiratory involvement. Refer to the change logs for specific coding details.
• Procedures that are no longer recognized as operating room procedures were removed from the ORPROC format.
• Procedures used in the PDI 05 and PSI 06 (Iatrogenic Pneumothorax Rate for pediatrics and adults) to identify thoracic surgery in the THORAIP format/setname were updated to exclude low risk procedures or procedures that are unlikely to cause non-preventable pneumothorax.
• Diagnosis codes that are exempt from present on admission (POA) classification in the v35 CMS grouper were added to POA exempt format.

All measures that use the ICD-10 CM/PCS coding standards may see some variation in rates resulting from the transition in coding systems. ´óÏóÊÓƵrecommends using v2018 rates as a starting point for internal assessment and not for comparison across providers. Users may review discharge-level results to determine if evidence in the administrative record indicates occurrence of an adverse event.

Further information about the ICD-10- CM/PCS transition and use of administrative data is available at: .

Quality Indicator(QI) users with the v2018 ´óÏóÊÓƵQI software do not need to make any changes. In the v2018 QI software population file, ´óÏóÊÓƵhas changed the process to use single year age bands provided by the U.S. Census based on county vintage estimates for 2000 through 2017.

The ´óÏóÊÓƵQI Program discovered that the QI population files (v7.0 1995-2017 population file) contained some inaccurate county-level, age-, sex-, and race-specific population estimates beginning with the 2012 calendar year. The inaccurate population estimates affect the rates of all area-level indicators only and does not affect any provider level indicators. The inaccurate population estimates also affects rates of the following area-level indicators retired in v7.0:

• Prevention Quality Indicators (PQIs), and area-level Pediatric Quality Indicators (PDI 14-PDI 18, PDI 90-PDI 92).
• Patient Safety Indicators (PSI 21-PSI 27).
• Inpatient Quality Indicators (IQI 26-IQI 29).

The updated QI population file is available as a .

´óÏóÊÓƵprovides the software to any interested organization for use with their own hospital discharge data. The Quality Indicators software is designed to read hospital administrative discharge data that generally conforms to HCUP specifications, in which each hospitalization is reported on a single record.

The software expects that the DRG or ICD-9 code on any given discharge record is valid for the fiscal year of the discharge date. The software is designed to be backwards compatible with previous fiscal year versions. The ´óÏóÊÓƵQI software is intended to be used with data that cover an entire patient population (e.g., all discharges from a hospital in a year) or that were sampled from a patient population using simple random sample.

The software only accepts three common data formats: Text (comma separated values), Microsoft Access®, and Microsoft Excel®. Two key formatting issues are that each row of data represents a separate discharge record and each column of data represents a single variable for all discharges.

The support email address for the ´óÏóÊÓƵQuality Indicators is QIsupport@ahrq.hhs.gov.

The ´óÏóÊÓƵQuality Indicators support team can also be reached by phone in the USA at (301) 427-1949. Messages are responded to within three business days.

For information on preparing for surgery, go to the Getting Ready for Your Ambulatory Surgery brochure.

The "10 Questions To Ask Your Doctor" are on the ´óÏóÊÓƵwebsite at /patients-consumers/patient-involvement/ask-your-doctor/index.html.

´óÏóÊÓƵprovides impact case studies for online access. These highlight how research and resources result in changes in clinical practice, policy, and patient outcomes or the way that evidence-based tools and findings are disseminated and implemented in the health care system. You can search the available case studies in the Impact Case Studies database.

´óÏóÊÓƵis interested in feedback from the private and public sectors on how our research and products impact organizations, service delivery, and quality of care. If you are willing to provide feedback on your experience with examples of use for inclusion as a featured case study, please contact the Agency at: casestudies@ahrq.hhs.gov.