Validation of the joint commission exclusion criteria for elective early-term delivery.

Abstract:

OBJECTIVE:To evaluate whether current Joint Commission (JC) exclusion criteria for measure PC-01, "Elective Delivery" before 39 weeks of gestation, accurately identify valid, codeable indications for planned early-term delivery. METHODS:We performed a review and critical analysis of all cases recorded as noncompliant for the measure in a large health care system during the second half of 2012. RESULTS:During the study period, of 107,145 total deliveries, 205 cases were reported as noncompliant with PC-01. Ten percent of compliance fallouts (ie, cases coded as noncompliant) resulted from valid indications for delivery identifiable by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) coding not included on the JC exclusion list; these were primarily unusual or extreme variations of these conditions. Twenty-five percent of fallouts represented valid indications not represented by an ICD-9-CM code. Eight percent of cases were reported as fallouts as a result of imprecise physician charting; only 2% represented chart abstraction errors. Fifty-five percent of cases involved stated indications for early-term delivery not generally recognized as such by the medical community. Compliance rates of 98% are achievable across a large population using the current ICD-9-CM-based metric for compliance assessment used by the JC (PC-01). The current exclusion list does not appear to be amenable to further improvement by inclusion of more or different ICD-9-CM codes. However, given the low volumes generated using the current PC-01 denominator definition, approximately 60% of facilities would have compliance rates below a 95% benchmark with even a single justified outlier if analyzed on a quarterly basis. CONCLUSION:Our data validate the current JC exclusion criteria for this measure, which identify the vast majority of valid indications for early-term delivery used by obstetrician-gynecologists and identifiable with ICD-9-CM codes. LEVEL OF EVIDENCE:III.

journal_name

Obstet Gynecol

authors

Clark SL,Meyers JA,Milton CG,Frye DR,Horner S,Baker A,Perlin JB

doi

10.1097/AOG.0000000000000059

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

29-33

issue

1

eissn

0029-7844

issn

1873-233X

pii

00006250-201401000-00006

journal_volume

123

pub_type

杂志文章
  • Factors affecting survival in stage I and state II carcinoma of the cervix.

    abstract::Eighty-eight cases of Stage I and Stage II carcinoma of the cervix treated with radiotherapy at the University of North Carolina Memorial Hospital between April 1969 and July 1971 are reviewed. The question of whether the radiation time-dose-fraction relationship can be applied to the combination of external beam and ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Welander CE,Montana GS,Saylor WL,Palumbo L,Fowler W

    更新日期:1975-10-01 00:00:00

  • Postpartum Rh immunoprophylaxis.

    abstract::The postpartum dose of Rh immune globulin varies according to an individual laboratory estimation of fetal red blood cells in each mother's peripheral blood. In the United States, a four-step procedure determines the postpartum dose (number of vials of 300 micrograms; 1,500 international units) of Rh immune globulin (...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/aog.0b013e3182742eba

    authors: Sandler SG,Gottschall JL

    更新日期:2012-12-01 00:00:00

  • Ovarian arteriovenous fistula. An unusual cause of abdominal pain.

    abstract::Arteriovenous fistulae of the ovarian artery may develop after gynecologic surgery. A case that occurred 9 years after hysterectomy with bilateral oophorectomy is presented and discussed. It illustrates an unusual cause of left lower quadrant abdominal pain. Surgical removal of the ovarian arteriovenous fistula result...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Swenson WM,Tolstedt GE,Ramos P,Peters CH

    更新日期:1978-01-01 00:00:00

  • Fetal cerebral Doppler studies as a predictor of perinatal outcome and subsequent neurologic handicap.

    abstract:OBJECTIVE:To study the use of middle cerebral arterial Doppler findings in a group of high-risk fetuses as a predictor of adverse perinatal outcome, including subsequent neurologic handicap. METHODS:A group of very high-risk fetuses was recruited over a 2-year period for study. Weekly fetal biometries and Doppler stud...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(96)00062-2

    authors: Chan FY,Pun TC,Lam P,Lam C,Lee CP,Lam YH

    更新日期:1996-06-01 00:00:00

  • Quintuplet pregnancy.

    abstract::A quintuplet gestation after ovulation induction with clomiphene and HCG is described. This is the first quintuplet birth reported in Israel. The pregnancy was associated with ovarian hyperstimulation syndrome, toxemia of pregnancy, and pruritus gravidarum. Diagnosis and management of these cases pose a special proble...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Schenker JG,Simha A

    更新日期:1975-05-01 00:00:00

  • Maternal and fetal outcome of Lamaze-prepared patients.

    abstract::To determine whether Lamaze childbirth preparation is harmless, harmful, or beneficial, 500 consecutive Lamaze-prepared patients were compared to 500 hand-picked controls, matched for age, race, parity, and educational level. Lamaze preparation was found to have a significant beneficial effect in almost every obstetri...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Hughey MJ,McElin TW,Young T

    更新日期:1978-06-01 00:00:00

  • Amniotic fluid cortisol as an index of fetal lung maturity.

    abstract::Amniotic fluid cortisol concentration was compared with lecithin/sphingomyelin ratio, gestational age, and eventual birth-weight in a large series of normal and high-risk human pregnancies in an effort to determine whether cortisol could be used as a reliable indicator of fetal maturity. It appears that when used alon...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Gewolb IH,Hobbins JC,Tan SY

    更新日期:1977-04-01 00:00:00

  • Mastocytosis complicating pregnancy.

    abstract:OBJECTIVE:To review the experience of women who conceived after developing mastocytosis and who were observed at the National Institutes of Health. METHODS:We reviewed our patient database for the years 1984-1998 to identify women with mastocytosis who had conceived. We then reviewed each woman's record, asked each wo...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(99)00591-8

    authors: Worobec AS,Akin C,Scott LM,Metcalfe DD

    更新日期:2000-03-01 00:00:00

  • Adenomyosis: symptoms, histology, and pregnancy terminations.

    abstract:OBJECTIVE:To correlate symptoms of uterine adenomyosis with histopathologic features. METHODS:One hundred eleven specimens of uteri and cervices that weighed under 280 g were reevaluated. When adenomyosis was identified, assessment included depth of adenomyotic foci, graded as deep (above 80%), intermediate (40-80%), ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(99)00659-6

    authors: Levgur M,Abadi MA,Tucker A

    更新日期:2000-05-01 00:00:00

  • Enzyme assays to detect preovulatory human luteinizing hormone surge.

    abstract::Nonradioisotopic enzyme assays have been developed to detect the preovulatory luteinizing hormone (LH) surge in the unextracted urine of normally menstruating women. The amino groups on 6-mm glass beads were activated and coupled to the anti-LH-gamma-globulin for enzyme immunoassay or to the LH receptor prepared from ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Fukunaga T,Rathnam P,Landesman R,Saxena BB

    更新日期:1983-01-01 00:00:00

  • Ovarian hyperstimulation syndrome caused by pituitary gonadotroph adenoma secreting follicle-stimulating hormone.

    abstract:BACKGROUND:We report a highly exceptional case in which a gonadotroph adenoma was diagnosed in a patient with normal follicle-stimulating hormone (FSH) levels. CASE:A 30-year-old woman with a gonadotroph adenoma presented with hyperstimulation syndrome and normal FSH levels. After treatment of her adenoma she had regu...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000247316.60573.4a

    authors: Ghayuri M,Liu JH

    更新日期:2007-02-01 00:00:00

  • Diagnosis of chlamydial infection in pregnant women using the Testpack Chlamydia diagnostic kit.

    abstract::We compared the performance of Testpack Chlamydia to tissue culture isolation for detection of endocervical chlamydia in an obstetric clinic population at high risk for infection. Among 227 evaluable patients, 30 tissue culture-confirmed chlamydial infections were found (13.2%). The sensitivity, specificity, and posit...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Grossman JH 3rd,Rivlin ME,Morrison JC

    更新日期:1991-05-01 00:00:00

  • Primary cesarean section: factors related to postpartum infection.

    abstract::Four hundred sixty-five primary cesarean sections (10.4% of total deliveries) performed during 1977 and 1978 were reviewed and compared with 465 vaginal deliveries to ascertain factors that may be related to postpartum infection. The overall morbidity (19.7%) related to postpartum infection in the primary cesarean sec...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Ott WJ

    更新日期:1981-02-01 00:00:00

  • Early oral intake and gastrointestinal function after cesarean delivery: a systematic review and meta-analysis.

    abstract:OBJECTIVE:To evaluate whether early oral intake after cesarean delivery has an effect on gastrointestinal outcomes during postpartum recovery. DATA SOURCES:Electronic searches of published studies between 1980 and 2011 were conducted using PubMed, Medline, CINAHL, ClinicalTrials.gov, and Airiti databases. METHODS OF ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/AOG.0b013e318293698c

    authors: Hsu YY,Hung HY,Chang SC,Chang YJ

    更新日期:2013-06-01 00:00:00

  • Fertility and pregnancy complications in women with autosomal dominant polycystic kidney disease.

    abstract::Fertility and pregnancy complications were assessed in 137 women at risk of having inherited the gene for autosomal dominant polycystic kidney disease. Seventy-six (55%) of these subjects were found to have polycystic kidney disease (multiple renal cysts). The remaining 61 women served as controls. The prevalence of f...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Milutinovic J,Fialkow PJ,Agodoa LY,Phillips LA,Bryant JI

    更新日期:1983-05-01 00:00:00

  • Long-term effect of tubal sterilization on menstrual indices and pelvic pain.

    abstract:OBJECTIVE:To evaluate the long-term effect of tubal sterilization on menstrual indices and pelvic pain. METHODS:Five hundred women undergoing sterilization were interviewed before sterilization, 6-10 months after surgery, and 3-4.5 years later. Four hundred sixty-six non-sterilized comparison women were interviewed in...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Rulin MC,Davidson AR,Philliber SG,Graves WL,Cushman LF

    更新日期:1993-07-01 00:00:00

  • Intrapartum bacteriuria and postpartum endometritis.

    abstract::Ten gravidas with bacteriuria in the immediate antepartum period subsequently delivered vaginally and did not receive antibiotic therapy. Four of these women developed postpartum endometritis and in three of them, the same Enterobacteriaceae recovered from the urine was present in the endometrial cultures. Of the 1233...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Monif GR

    更新日期:1991-08-01 00:00:00

  • Effect of body mass index and excessive weight gain on success of vaginal birth after cesarean delivery.

    abstract:OBJECTIVE:To estimate whether excessive weight gain or obesity are risk factors affecting success for vaginal birth after cesarean (VBAC). METHODS:Patients attempting VBAC were identified by the International Classification of Diseases, 9th Revision, codes "VBAC" and "non-primary C-section" and by reviewing logbooks o...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000177972.32941.65

    authors: Juhasz G,Gyamfi C,Gyamfi P,Tocce K,Stone JL

    更新日期:2005-10-01 00:00:00

  • Obstetric and gynecologic operations in the United States, 1979 to 1984.

    abstract::An in-depth analysis of numbers of obstetric and gynecologic operations from 1979 to 1984 was performed using data from the National Center for Health Statistics. During the study period, there was a decrease in total numbers of obstetric and gynecologic procedures of 1%. During the same five-year period the numbers o...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00006250-198606000-00001

    authors: Rutkow IM

    更新日期:1986-06-01 00:00:00

  • Screening and Management of the Hyperandrogenic Adolescent: ACOG Committee Opinion Summary, Number 789.

    abstract::Although androgen excess can manifest in many ways, the most common and recognizable symptoms are hirsutism and acne. Reports of hirsutism and acne should be taken seriously because of their possible association with medical disorders, their substantial effect on self-esteem and quality of life, and the potential for ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,实务指引

    doi:10.1097/AOG.0000000000003477

    authors:

    更新日期:2019-10-01 00:00:00

  • Recurrent streptococcal cellulitis complicating radical hysterectomy and radiation therapy.

    abstract::Reported is a rare complication of radical hysterectomy and radiation therapy, recurrent streptococcal cellulitis. Two patients had 14 episodes over a nine-year period, characterized by high fever and systemic toxicity. The streptococcal cellulitis was atypical in its presentation and its causative organism. The rash ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Chmel H,Hamdy M

    更新日期:1984-06-01 00:00:00

  • Letter: Case of the "missing strings".

    abstract::A method of removing an IUD whose strings may be lost is discussed. Having identified the intrauterine location of the IUD by touch with probe, a second Lippes loop was placed and the long strings not trimmed at all. When the patient returned later the most recently placed loop was removed and the strings of the fir...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Evans GT

    更新日期:1974-07-01 00:00:00

  • Career Expectations of Obstetrics and Gynecology Residents and Future Residents.

    abstract:OBJECTIVE:To understand contemporary fourth-year medical student and resident career expectations in obstetrics and gynecology. METHODS:Students invited for obstetrics and gynecology residency interviews and residents (postgraduate years 1-4) at the University of Colorado, University of Washington, University of Calif...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000002817

    authors: Alston MJ,Ehrig J,Autry AM,Wagner SA,Kohl-Thomas BM,Allshouse AA,Gottesfeld M,Stephenson-Famy A

    更新日期:2018-10-01 00:00:00

  • Intrauterine anesthesia for gynecologic procedures: a systematic review.

    abstract:OBJECTIVE:To assess the effectiveness of intrauterine local anesthesia in reducing pain associated with outpatient gynecologic procedures. DATA SOURCES:We searched online databases PubMed or MEDLINE, Embase, Google Scholar, and Clinicaltrials.gov and hand-searched reference lists from reviews evaluating pain-control m...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/AOG.0b013e3182639ab5

    authors: Mercier RJ,Zerden ML

    更新日期:2012-09-01 00:00:00

  • Pregnancy after successful vaginoplasty and cervical stenting for partial atresia of the cervix.

    abstract::We previously reported surgical correction of vaginal agenesis and partial cervical atresia in an 11-year-old girl with amenorrhea and a pelvic mass. This patient, the subject of this report, conceived 7 years later and delivered at term. An abdominal cerclage was placed at 12 weeks' gestation to protect the cervix, a...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00006250-199011001-00001

    authors: Hampton HL,Meeks GR,Bates GW,Wiser WL

    更新日期:1990-11-01 00:00:00

  • Pathophysiologic Origins of Brachial Plexus Injury.

    abstract:OBJECTIVE:To analyze the origins and consequences of cases of brachial plexus injuries and their relationship to shoulder dystocia. METHODS:We conducted a retrospective cohort study and identified all neonates with brachial plexus injury delivered at our institution between March 2012 and July 2019. A review was perfo...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000004013

    authors: Johnson GJ,Denning S,Clark SL,Davidson C

    更新日期:2020-10-01 00:00:00

  • Effect of estrogen replacement therapy on bone mineral content in girls with Turner syndrome.

    abstract::Because a close relationship between estrogen deficiency and osteoporosis has been proven, it is possible that lifelong estrogen deficiency might be the cause of osteopenia in Turner syndrome. This study was done to characterize the effect of estrogen therapy on bone mineralization in girls with Turner syndrome. Radia...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Mora S,Weber G,Guarneri MP,Nizzoli G,Pasolini D,Chiumello G

    更新日期:1992-05-01 00:00:00

  • Management of the selected term breech presentation: assessment of the risks of selected vaginal delivery versus cesarean section for all cases.

    abstract::In this study, the concepts of decision theory have been applied to a clinical obstetric controversy--the management of the selected mature breech presentation. We have reviewed in detail the literature published since 1974 and estimated the probabilities of various outcomes after different treatment strategies. We co...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:

    authors: Bingham P,Lilford RJ

    更新日期:1987-06-01 00:00:00

  • Direct laparoscopic entry using a sharp and dull trocar technique.

    abstract::For direct laparoscopic entry using a sharp and dull trocar technique, the sharp trocar is inserted with a twisting motion under constant pressure, then replaced with a dull trocar when a slight loss of resistance is felt. A slow, gradual entry into the peritoneal cavity is accomplished by twisting the dull trocar und...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(96)00215-3

    authors: Hasaniya NW,Kosasa TS,Shieh T,Nakayama RT

    更新日期:1996-10-01 00:00:00

  • Middle cerebral artery velocimetry: different clinical relevance depending on umbilical velocimetry.

    abstract:OBJECTIVE:To evaluate the role of cerebral velocimetry as a predictor of perinatal outcome in high-risk pregnancies. METHODS:Middle cerebral artery pulsatility index was measured in 576 high-risk pregnancies undergoing umbilical velocimetry. The results of both tests were evaluated with respect to the birth of small f...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00482-1

    authors: Strigini FA,De Luca G,Lencioni G,Scida P,Giusti G,Genazzani AR

    更新日期:1997-12-01 00:00:00