Dimensional Warehouse Model Data Model

Entity

Entity AHRQ - Patient Safety Indicators

Description

The Patient Safety Indicators (PSIs) are a set of indicators providing information on potential in hospital complications and adverse events following surgeries, procedures, and childbirth. The PSIs were developed after a comprehensive literature review, analysis of ICD-9-CM codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses.

The PSIs can be used to help hospitals identify potential adverse events that might need further study; provide the opportunity to assess the incidence of adverse events and in hospital complications using administrative data found in the typical discharge record; include indicators for complications occurring in hospital that may represent patient safety events; and, indicators also have area level analogs designed to detect patient safety events on a regional level.

Attributes
Calendar Dk
Diagnosis Code Dk
Encounter Dk
EXP 01 Rate Of Complications Of Anesthesia
EXP 02 Obstetric Trauma Rate Cesarean Delivery
Patient Dk
Point Of Care Location Dk
Practitioner Dk
Provider Dk
PSI 02 Death Rate In Low Mortality DRGs
PSI 03 Pressure Ulcer Rate
PSI 04 Death Among Surgical Inpatients
PSI 05 Retained Surgical Item or Unretrieved Device Fragment Count
PSI 06 Iatrogenic Pneumothorax Rate
PSI 07 CVC Related Bloodstream Infection Rate
PSI 08 PostOp Hip Fracture Rate
PSI 09 PostOp Hemorrhage Or Hematoma Rate
PSI 10 PostOp Physiologic And Metabolic Derangement Rate
PSI 11 PostOp Respiratory Failure Rate
PSI 12 PostOp PE Or DVT Rate
PSI 13 PostOp Sepsis Rate
PSI 14 PostOp Wound Dehiscence Rate
PSI 15 Accidental Puncture Or Laceration Rate
PSI 16 Transfusion Reaction Count
PSI 17 Birth Trauma Rate - Injury To Neonate
PSI 18 Obstetric Trauma Rate - Vaginal Delivery With Instrument
PSI 19 Obstetric Trauma Rate - Vaginal Delivery Without Instrument
PSI 21 Retained Surgical Item or Unretrieved Device Fragment Rate
PSI 22 Iatrogenic Pneumothorax Rate
PSI 23 CVC Related Bloodstream Infection Rate
PSI 24 PostOp Wound Dehiscence Rate
PSI 25 Accidental Puncture Or Laceration Rate
PSI 26 Transfusion Reaction Rate
PSI 27 PostOp Hemorrhage Or Hematoma Rate
PSI 90 Patient Safety For Selected Indicators

Relationship
AHRQ - Patient Safety Indicators_Encounter Dimension_FK
AHRQ - Patient Safety Indicators_Patient Dimension_FK
AHRQ - Patient Safety Indicators_Practitioner Dimension_FK
AHRQ - Patient Safety Indicators_Provider Dimension_FK
AHRQ - Patient Safety Indicators_Calendar Dimension_FK
AHRQ - Patient Safety Indicators_Point Of Care Location Dimension_FK
AHRQ - Patient Safety Indicators_Diagnosis Dimension_FK

Primary Key
AHRQ - Patient Safety Indicators PK

Dependencies
NONE

Reverse Dependencies

Attribute Details

Calendar Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Diagnosis Code Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Encounter Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

EXP 01 Rate Of Complications Of Anesthesia

Description	Discharges with adverse effects or poisoning from anesthetics (secondary diagnosis) per 1,000 surgical discharges for patients ages 18 years and older or obstetric cases. Excludes cases with a principal diagnosis of adverse effects or poisoning from anesthetics; cases with a secondary diagnosis of adverse effects or poisoning from anesthetics present on admission; and cases with secondary diagnosis of poisoning by anesthetics and a diagnosis of self-inflicted injury, active drug dependence, or nondependent abuse of drugs. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for adverse effects of anesthetics or any secondary ICD-9-CM diagnosis codes for poisoning by anesthetics. Denominator: Surgical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any-listed ICD-9-CM procedure codes for an operating room procedure. Surgical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

EXP 02 Obstetric Trauma Rate Cesarean Delivery

Description	Third and fourth degree obstetric trauma diagnoses or obstetric trauma procedures per 1,000 Cesarean deliveries. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any-listed ICD-9-CM diagnosis codes for third and fourth degree obstetric trauma or any-listed ICD-9-CM procedure codes for obstetric trauma. Denominator: Cesarean deliveries, identified by DRG or MS-DRG code. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Patient Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Point Of Care Location Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Practitioner Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Provider Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

PSI 02 Death Rate In Low Mortality DRGs

Description	In-hospital deaths per 1,000 discharges for low mortality ( 0.5%) Diagnosis Related Groups (DRGs) among patients ages 18 years and older or obstetric patients. Excludes cases with trauma, cases with cancer, cases with an immunocompromised state, and transfers to an acute care facility. Numerator: Number of deaths (DISP=20) among cases meeting the inclusion and exclusion rules for the denominator. Denominator: Discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with a low-mortality (less than 0.5%) DRG or MS-DRG code. If a DRG or MS-DRG is divided into “without/with complications,” both DRG or MS-DRG codes must have mortality rates below 0.5% to qualify for inclusion. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 03 Pressure Ulcer Rate

Description	Stage III or IV pressure ulcers (secondary diagnosis) per 1,000 discharges among patients ages 18 years and older. Excludes stays less than 5 days; cases with a principal diagnosis of pressure ulcer; cases with a secondary diagnosis of Stage III or IV pressure ulcer that is present on admission; cases with diseases of the skin, subcutaneous tissue and breast; obstetric cases; cases with hemiplegia, paraplegia, quadriplegia, spina bifida, or anoxic brain damage; cases in which debridement or pedicle graft is the only operating room procedure; discharges with debridement or pedicle graft before or on the same day as the major operating room procedure; and transfers from another facility. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for pressure ulcer and any secondary ICD-9-CM diagnosis codes for pressure ulcer stage III or IV (or unstageable). Denominator: Surgical and medical discharges, for patients ages 18 years and older. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 04 Death Among Surgical Inpatients

Description	Death Rate among Surgical Inpatients with Serious Treatable Complications In-hospital deaths per 1,000 surgical discharges, among patients ages 18 through 89 years or obstetric patients, with serious treatable complications (pneumonia, pulmonary embolism/deep vein thrombosis, sepsis, shock/cardiac arrest or gastrointestinal hemorrhage/acute ulcer). Includes metrics for the number of discharges for each type of complication. Excludes cases transferred to an acute care facility. Numerator: Number of deaths (DISP=20) among cases meeting the inclusion and exclusion rules for the denominator. Denominator: Surgical discharges, for patients ages 18 through 89 years or MDC 14 (pregnancy, childbirth, and puerperium), with all of the following: • any-listed ICD-9-CM procedure codes for an operating room procedure; and • the principal procedure occurring within 2 days of admission or an admission type of elective (ATYPE=3); and • meet the inclusion and exclusion criteria for Stratum A (pneumonia), Stratum B (pulmonary embolism or deep vein thrombosis), Stratum C (sepsis), Stratum D (shock or cardiac arrest), or Stratum E (gastrointestinal hemorrhage or acute ulcer) defined below. Surgical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 05 Retained Surgical Item or Unretrieved Device Fragment Count

Description	The number of hospital discharges with a retained surgical item or unretrieved device fragment (secondary diagnosis) among surgical and medical patients ages 18 years and older or obstetric patients. Excludes cases with principal diagnosis of retained surgical item or unretrieved device fragment and cases with a secondary diagnosis of retained surgical item or unretrieved device fragment present on admission. Numerator: Surgical and medical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any secondary ICD-9-CM diagnosis codes for retained surgical item or unretrieved device fragment. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: N/A Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 06 Iatrogenic Pneumothorax Rate

Description	Iatrogenic pneumothorax cases (secondary diagnosis) per 1,000 surgical and medical discharges for patients ages 18 years and older. Excludes cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic surgery repair, or cardiac procedures; cases with a principal diagnosis of iatrogenic pneumothorax; cases with a secondary diagnosis of iatrogenic pneumothorax present on admission; and obstetric cases. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for iatrogenic pneumothorax. Denominator: Surgical and medical discharges, for patients ages 18 years and older. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Description	Central venous catheter-related bloodstream infections (secondary diagnosis) per 1,000 medical and surgical discharges for patients ages 18 years and older or obstetric cases. Excludes cases with a principal diagnosis of a central venous catheter-related bloodstream infection, cases with a secondary diagnosis of a central venous catheter-related bloodstream infection present on admission, cases with stays less than 2 days, cases with an immunocompromised state, and cases with cancer. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for selected infections. Denominator: Surgical and medical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium). Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 08 PostOp Hip Fracture Rate

Description	Postoperative hip fracture (secondary diagnosis) per 1,000 surgical discharges for patients ages 18 years and older. Excludes cases that are susceptible to falling (seizure disorder, syncope, stroke, occlusion of arteries, coma, cardiac arrest, poisoning, trauma, delirium or other psychoses, anoxic brain injury, metastatic cancer, lymphoid malignancy, bone malignancy, disorders of the musculoskeletal system, and disorders of connective tissue), cases with self-inflicted injury, cases with a principal diagnosis of hip fracture, cases with a secondary diagnosis of hip fracture present on admission, and obstetric cases. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for hip fracture. Denominator: Surgical discharges, ages 18 years and older, with any-listed ICD-9-CM procedure codes for an operating room procedure. Surgical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 09 PostOp Hemorrhage Or Hematoma Rate

Description	Perioperative hemorrhage or hematoma cases with control of perioperative hemorrhage, drainage of hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure following surgery per 1,000 surgical discharges for patients ages 18 years and older. Excludes cases with a diagnosis of coagulation disorder; cases with a principal diagnosis of perioperative hemorrhage or hematoma; cases with a secondary diagnosis of perioperative hemorrhage or hematoma present on admission; cases where the only operating room procedure is control of perioperative hemorrhage, drainage of hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure; and obstetric cases. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator Denominator: Surgical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for an operating room procedure. Surgical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 10 PostOp Physiologic And Metabolic Derangement Rate

Description	Postoperative physiologic and metabolic derangements (secondary diagnosis) or acute renal failures (secondary diagnosis) with dialysis per 1,000 elective surgical discharges for patients ages 18 years and older. Excludes cases with principal diagnosis for physiologic and metabolic derangement or acute renal failure; cases with secondary diagnosis for physiologic and metabolic derangement or acute renal failure present on admission; cases with secondary diagnosis of acute renal failure and dialysis before or on the same day as the first operating room procedure; cases with derangement and diabetes; cases with acute renal failure and acute myocardial infarction, cardiac arrhythmia, cardiac arrest, shock, hemorrhage, gastrointestinal hemorrhage or chronic renal failure; and obstetric cases. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator Denominator: Elective surgical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for an operating room procedure. Elective surgical discharges are defined by specific DRG or MS-DRG codes with admission type recorded as elective (SID ATYPE=3). Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 11 PostOp Respiratory Failure Rate

Description	Postoperative respiratory failure (secondary diagnosis), mechanical ventilation, or reintubation cases per 1,000 elective surgical discharges for patients ages 18 years and older. Excludes cases with principal diagnosis for acute respiratory failure; cases with secondary diagnosis for acute respiratory failure present on admission; cases in which tracheostomy is the only operating room procedure or in which tracheostomy occurs before the first operating room procedure; cases with neuromuscular disorders, laryngeal or pharyngeal surgery, craniofacial anomalies that had a procedure for the face, esophageal resection, lung cancer, or degenerative neurological disorders; cases with a procedure on the nose, mouth, or pharynx; cases with respiratory or circulatory diseases; and obstetric discharges. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator Denominator: Elective surgical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for an operating room procedure. Elective surgical discharges are defined by specific DRG or MS-DRG codes with admission type recorded as elective (SID ATYPE=3). Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 12 PostOp PE Or DVT Rate

Description	Perioperative pulmonary embolism or deep vein thrombosis (secondary diagnosis) per 1,000 surgical discharges for patients ages 18 years and older. Excludes cases with principal diagnosis for pulmonary embolism or deep vein thrombosis; cases with secondary diagnosis for pulmonary embolism or deep vein thrombosis present on admission; cases in which interruption of vena cava is the only operating room procedure or in which interruption of vena cava occurs before or on the same day as the first operating room procedure; and obstetric discharges. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with a secondary ICD-9-CM diagnosis code for deep vein thrombosis or a secondary ICD-9-CM diagnosis code for pulmonary embolism. Denominator: Surgical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for an operating room procedure. Surgical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 13 PostOp Sepsis Rate

Description	Postoperative sepsis cases (secondary diagnosis) per 1,000 elective surgical discharges for patients ages 18 years and older. Excludes cases with a principal diagnosis of sepsis, cases with a secondary diagnosis of sepsis present on admission, cases with a principal diagnosis of infection, cases with a secondary diagnosis of infection present on admission (only if they also have a secondary diagnosis of sepsis), cases with an immunocompromised state, cases with cancer, obstetric discharges, and cases with stays less than four (4) days. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for sepsis. Denominator: Elective surgical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for an operating room procedure. Elective surgical discharges are defined by specific DRG or MS-DRG codes with admission type recorded as elective (SID ATYPE=3). Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 14 PostOp Wound Dehiscence Rate

Description	Postoperative reclosures of the abdominal wall per 1,000 abdominopelvic surgery discharges for patients ages 18 years and older. Excludes cases in which the abdominal wall reclosure occurs on or before the day of the first abdominopelvic surgery, cases with an immunocompromised state, cases with stays less than two (2) days, and obstetric cases. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any-listed ICD-9-CM procedure codes for reclosure of postoperative disruption of the abdominal wall. Denominator: Discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for abdominopelvic surgery. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 15 Accidental Puncture Or Laceration Rate

Description	Accidental punctures or lacerations (secondary diagnosis) during procedure per 1,000 discharges for patients ages 18 years and older. Excludes cases with accidental puncture or laceration as a principal diagnosis, cases with accidental puncture or laceration as a secondary diagnosis that is present on admission, spinal surgery cases, and obstetric cases. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any secondary ICD-9-CM diagnosis codes for accidental puncture or laceration during a procedure. Denominator: Surgical and medical discharges, for patients ages 18 years and older. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 16 Transfusion Reaction Count

Description	The number of medical and surgical discharges with a secondary diagnosis of transfusion reaction for patients ages 18 years and older or obstetric patients. Excludes cases with a principal diagnosis of transfusion reaction or cases with a secondary diagnosis of transfusion reaction that is present on admission. Numerator: Surgical and medical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any secondary ICD-9-CM diagnosis codes for transfusion reaction. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: N/A Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 17 Birth Trauma Rate - Injury To Neonate

Description	Birth trauma injuries per 1,000 newborns. Excludes preterm infants with a birth weight less than 2,000 grams, cases with injury to brachial plexus, and cases with osteogenesis imperfecta. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any-listed ICD-9-CM diagnosis codes for birth trauma. Denominator: All newborns Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 18 Obstetric Trauma Rate - Vaginal Delivery With Instrument

Description	Third and fourth degree obstetric traumas per 1,000 instrument-assisted vaginal deliveries. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any-listed ICD-9-CM diagnosis codes for third and fourth degree obstetric trauma. Denominator: Vaginal deliveries, identified by DRG or MS-DRG code, with any-listed ICD-9-CM procedure codes for instrument-assisted delivery. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 19 Obstetric Trauma Rate - Vaginal Delivery Without Instrument

Description	Third and fourth degree obstetric traumas per 1,000 vaginal deliveries. Excludes cases with instrument-assisted delivery. Numerator: Discharges, among cases meeting the inclusion and exclusion rules for the denominator, with any-listed ICD-9-CM diagnosis codes for third and fourth degree obstetric trauma. Denominator: Vaginal deliveries, identified by DRG or MS-DRG code. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 21 Retained Surgical Item or Unretrieved Device Fragment Rate

Description	Retained surgical item or unretrieved device fragment cases per 100,000 population, ages 18 years and older. Numerator: Surgical and medical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any-listed ICD-9-CM diagnosis codes for retained surgical item or unretrieved device fragment. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: Population ages 18 years and older in metropolitan area† or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 22 Iatrogenic Pneumothorax Rate

Description	Iatrogenic pneumothorax cases per 100,000 population, ages 18 years and older. Excludes obstetric cases and cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic surgery repair, or cardiac procedures. Numerator: Surgical and medical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM diagnosis codes for iatrogenic pneumothorax. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: Population ages 18 years and older in metropolitan area or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Description	Central venous catheter-related bloodstream infections per 100,000 population, ages 18 years and older. Excludes cases with an immunocompromised state and cases with cancer. Numerator: Surgical and medical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any-listed ICD-9-CM diagnosis codes for selected infections. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: Population ages 18 years and older in metropolitan area or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 24 PostOp Wound Dehiscence Rate

Description	Postoperative reclosures of the abdominal wall per 100,000 population, ages 18 years and older. Excludes cases with an immunocompromised state and obstetric cases. Numerator: Discharges, for patients ages 18 years and older, with any-listed ICD-9-CM procedure codes for reclosure of postoperative disruption of the abdominal wall. Denominator: Population ages 18 years and older in metropolitan area† or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 25 Accidental Puncture Or Laceration Rate

Description	Accidental punctures or lacerations during a procedure per 100,000 population, ages 18 years and older. Excludes obstetric discharges and spinal surgery discharges. Numerator: Surgical and medical discharges, for patients ages 18 years and older, with any-listed ICD-9-CM diagnosis codes for accidental puncture or laceration during a procedure. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: Population ages 18 years and older in metropolitan area† or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 26 Transfusion Reaction Rate

Description	Transfusion reactions per 100,000 population, ages 18 years and older. Numerator: Surgical and medical discharges, for patients ages 18 years and older or MDC 14 (pregnancy, childbirth, and puerperium), with any-listed ICD-9-CM diagnosis codes for transfusion reaction. Surgical and medical discharges are defined by specific DRG or MS-DRG codes. Denominator: Population ages 18 years and older in metropolitan area† or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 27 PostOp Hemorrhage Or Hematoma Rate

Description	Perioperative hemorrhage or hematoma cases with control of perioperative hemorrhage, drainage of hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure following surgery per 100,000 population ages 18 years and older. Excludes cases with a diagnosis of coagulation disorder and obstetric cases. Numerator: Discharges, for patients ages 18 years and older, with either: - any secondary ICD-9-CM diagnosis codes for perioperative hemorrhage and any-listed ICD-9-CM procedure codes for control of perioperative hemorrhage; or - any secondary ICD-9-CM diagnosis codes for perioperative hemorrhage and any-listed ICD-9-CM procedure codes for drainage of hematoma; or - any secondary ICD-9-CM diagnosis codes for perioperative hemorrhage and any-listed ICD-9-CM procedure codes for miscellaneous hemorrhage- or hematoma-related procedure; or - any secondary ICD-9-CM diagnosis codes for perioperative hematoma and any-listed ICD-9-CM procedure codes for control of perioperative hemorrhage; or - any secondary ICD-9-CM diagnosis codes for perioperative hematoma and any-listed ICD-9-CM procedure codes for drainage of hematoma; or - any secondary ICD-9-CM diagnosis codes for perioperative hematoma and any-listed ICD-9-CM procedure codes for miscellaneous hemorrhage or hematoma-related procedure Denominator: Population ages 18 years and older in metropolitan area or county. Discharges in the numerator are assigned to the denominator based on the metropolitan area or county of the patient residence, not the metropolitan area or county of the hospital where the discharge occurred. Note: The procedure or diagnosis codes are continuously updated. See the latest measure descriptions published by AHRQ for the list of ICD-9-CM codes as well as notes about specific cases to exclude from the measure calculations.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

PSI 90 Patient Safety For Selected Indicators

Description	The weighted average of the observed-to-expected ratios for the following component indicators: • PSI #3 Pressure Ulcer Rate • PSI #6 Iatrogenic Pneumothorax Rate • PSI #7 Central Venous Catheter-Related Blood Stream Infection Rate • PSI #8 Postoperative Hip Fracture Rate • PSI #9 Perioperative Hemorrhage or Hematoma Rate • PSI #10 Postoperative Physiologic and Metabolic Derangement Rate • PSI #11 Postoperative Respiratory Failure Rate • PSI #12 Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate • PSI #13 Postoperative Sepsis Rate • PSI #14 Postoperative Wound Dehiscence Rate • PSI #15 Accidental Puncture or Laceration Rate The weights include component weights and shrinkage weights. The component weights are denominator weights, defined as the relative frequency of the denominators for the component indicators in the reference population. The shrinkage weights are the signal-to-noise ratio, where the signal variance is estimated from the reference population, and the noise variance is estimated from the user’s data and is unique to each provider in the user’s data.
Data Type	Standards - Data Domains.ddm/Data Domains/Rate [FLOAT(5)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Relationship Details

AHRQ - Patient Safety Indicators_Encounter Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Encounter Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

AHRQ - Patient Safety Indicators_Patient Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Patient Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

AHRQ - Patient Safety Indicators_Practitioner Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Practitioner Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

AHRQ - Patient Safety Indicators_Provider Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Provider Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

AHRQ - Patient Safety Indicators_Calendar Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Calendar Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

AHRQ - Patient Safety Indicators_Point Of Care Location Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Point Of Care Location Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

AHRQ - Patient Safety Indicators_Diagnosis Dimension_FK

Is Identifying Relationship	true
Child Table	AHRQ - Patient Safety Indicators
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Diagnosis Code Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Primary Key Details

AHRQ - Patient Safety Indicators PK

Key Attribute	Encounter Dk
Key Attribute	Patient Dk
Key Attribute	Practitioner Dk
Key Attribute	Provider Dk
Key Attribute	Calendar Dk
Key Attribute	Point Of Care Location Dk
Key Attribute	Diagnosis Code Dk

Overview

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Entity

Dimensional Warehouse Model Data Model