trauma room

In this situation, we recommend you NOT capture the unplanned OR hospital event.

There is no exclusion within the definition for the Hospital Event Unplanned Visit to the Operating Room for these situations. Therefore, I recommend you capture the hospital event in the registry.

There is no time limitation in the definition; therefore, if there is documentation the patient had substance use disorder at any time you must report the Hospital Event Substance Use Disorder. This is true even if there is documentation the patient is in remission.

NTDB has just confirmed to us that operative procedures do not need to occur in the OR, it is not tied to location. Their response was, “Some operative procedures are performed outside the OR. If the patient had an unplanned operative procedure you must report Element Value “1. Yes” to TQIP for the Unplanned Visit …

All events must occur after arrival at your hospital. If the aspiration occurred prior to arrival, it would not get picked up. If it occurred at a receiving facility, it would be on the receiving facility hospital events. It would get picked up at your hospital only if it occurred after arrival at your facility. …

Please refer to the Best Practices Guidelines for abuse. If you cannot locate this resource, please contact PTSF staff, and we can provide it for you. I hope this document helps clarify abuse for you. This resource provides great information, and best practices for abstraction as well. Any physical assault is not abuse. However, according …

Based on the information provided, it sounds like the patient’s tracheostomy procedure was not initially planned. Therefore, I do recommend capturing Hospital Event 212 for Unplanned Visit to the OR.

Yes, I recommend that you do also capture 212 – Unplanned Visit to the OR based on the information provided. I am making this recommendation because although the unplanned procedure is performed in IR and not the OR, the patient does have documentation of an unplanned operative procedure which is included in the definition.

PTSF recommends you capture both separately. That means spine would need to be recorded under the “other” option. Note that only Speech Therapy, Occupational Therapy, Physical Therapy, and Physiatry consults are required to be recorded for non-burn patients at a burn center and all patients at non-burn centers.

Yes, if they went to ICU post op, but it was not decided until after surgery started, then it is unplanned ICU. The NTDB has a couple questions on their FAQ that are similar. They are under “Unplanned Admission to ICU” if you scroll down the 2021 FAQ. The link is