March 15, 2024
We have a question regarding the exclusion/inclusion criteria. We previously reached out for clarification on this but upon reviewing with new staff I want to ensure we are capturing this correctly. If we have a patient that is transferred in from an outside hospital is in our ED and family wants hospice/comfort care we are to be including these as PTOS as the patient was transferred in, correct? However the below statement in the guidelines on page 16 is conflicting. We think that the bolded portion contradict one another, at least that’s how we are interrupting it. A patient discharged to hospice (in-house or outside), or the equivalent (i.e.palliative care, comfort care), directly from the ED or prior to meeting any portion of the PTOS inclusion criteria are NOT to be captured as PTOS. NOTE: A patient that meets the PTOS inclusion criteria prior to the order for hospice care, or the equivalent, should be captured as PTOS. Transfer in patients who are discharged to hospice directly from the ED are not to be captured as PTOS. If the order for hospice or equivalent care is rescinded and the patient receives treatment, the patient should be captured as PTOS if the patient meets the PTOS inclusion criteria.We have a question regarding the exclusion/inclusion criteria. We previously reached out for clarification on this but upon reviewing with new staff I want to ensure we are capturing this correctly. If we have a patient that is transferred in from an outside hospital is in our ED and family wants hospice/comfort care we are to be including these as PTOS as the patient was transferred in, correct? However the below statement in the guidelines on page 16 is conflicting. We think that the bolded portion contradict one another, at least that’s how we are interrupting it.
It depends on when the determination for hospice/comfort care is made. Transfer In is a qualifier, but specifically for hospice, if the determination for hospice/comfort care is made before patient leaves the ED, the patient should be excluded. If the patient went to a ward/unit/OR/post ED destination before the hospice/comfort care was ordered, they are included as PTOS.
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