How to Answer Develop Sbar Following Questions (Complete Guide)
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Original Question
can you develop an SBAR on the following: Solution: Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure calculates the percentage of emergency department (ED) encounters for patients 18 years and older with a diagnosis of STEMI that received appropriate treatment, defined as fibrinolytic therapy within 30 minutes of ED arrival, percutaneous coronary intervention (PCI) within 90 minutes of ED arrival, or discharge to a PCI-capable acute care facility within 45 minutes of ED arrival. A patient’s ED encounter should end when they are discharged from the ED, as indicated by an ED discharge disposition. In the scenario depicted in the inquiry, the ED encounter would end when the patient is transferred to the CCU at 14:00pm. If a mechanical circulatory assist device placement occurred during the ED encounter or 24 hours or less before the start of the ED encounter (such as insertion of an intra-aortic balloon pump) the encounter would be excluded from the measure denominator. The full list of corresponding clinical codes for this measure exclusion (i.e., value set: “Insertion or Replacement of Mechanical Circulatory Assist Device” (OID: 2.16.840.1.113883.3.3157.4052)) can be found here: https://vsac.nlm.nih.gov/valueset/expansions?pr=ecqm&rel=eCQM%20Update%202024-05-02&q=CMS996v5. Please note that you may need to create a free account to view the codes. In general, we highlight that PCI device deployment time should be used for calculating the numerator criterion: PCI performed within 90 minutes of ED arrival. Therefore, if this patient did not receive placement of a mechanical circulatory assist device during the encounter and was in fact captured in the measure denominator, they would not be captured in the measure numerator since balloon inflation occurred at 13:26pm, which was 118 minutes (>90 minutes) after ED arrival time (11:28am).
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