I have listed a scenario below. This is being questioned because the goal is always conservative treatment for a hospital and the patient and is it an unplanned event if the patient is taken to the OR? For example, if the patient is placed in a TLSO and the patient xray was done showing improper alignment and on 4/20 N/S states will take the patient to the OR for fixation on 4/21 and the patient is made NPO. Based off the most recent TQIP quiz, registry would determine this to be unplanned OR event due to failed conservative treatment.
PTOS aligns with the NTDB/TQIP for the Unplanned Visit to Operating Room Hospital Event.
If the initial plan for the patient included conservative management, and no surgery, but the patient declines and ends up needing more aggressive treatment and is taken to the OR, you would capture the Hospital Event Unplanned Visit to the Operating Room for PTOS as well as the NTDB/TQIP.
The only exclusion is for “pre-planned, staged and/or procedures for incidental findings.” Really, unless the OR is part of the patient’s initial plan, or the procedure is planned to explore further potential injuries for example, you will capture this hospital event. If you remember, the definition used to only capture re-admissions to the OR. Capturing all “unplanned” operative procedures is relatively new.
If you have concerns about the definition and would like to recommend that an exclusion be added to the definition, I recommend you submit a request through the NTDS Revision Site at https://web5.facs.org/ntdsrevisions.
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