PSI-17 Birth Trauma – Injury to the Neonate OB Adverse Event Affinity Call Lynne Hall 7/23/14

 What is an injury to the neonate?  Specifications of the PSI-17  Numerator/Denominator  What can be done?  Graph  Questions Framing

 Birth injury is defined as an impairment of the neonate's body function or structure due to an adverse event that occurred at birth.  Birth injury ranges from mild (bruising) to severe (death) Injury to the neonate

Risk Factors  Macrosomia  Maternal Obesity  Abnormal Fetal Presentation  Operative vaginal delivery  Cesarean Delivery Injury to the Neonate

Numerator:  To include only these codes: PSI Birth trauma Subdural and cerebral hemorrhage Injuries to scalp due to birth trauma Epicranial subaponeurotic hemorrhage (massive) Other injuries to skeleton due to birth trauma Injury to spine and spinal cord due to birth trauma Facial nerve injury due to birth trauma Other cranial and peripheral nerve injuries due to birth trauma Other specified birth trauma

 Denominator:  Exclusions:  Preterm infants with a birth weight less than 2000 grams  Infants with any diagnosis code of injury to the brachial plexus  Infants with any diagnosis code of osteogenesis imperfecta  Cases with missing gender, age, quarter, year, or principal diagnosis  specifications manual PSI-17

What is NOT a birth trauma  Petechiae  Mongolian Spots  Hemangiomas  Port-wine Nevi  What else? PSI-17

 In CY2013 there were 152 incidents of Neonatal Injury  Ranges include 0 incidents to 28 incidents  Please me if you would like your hospitals number of incidents: Neonatal Injury

 Review all cases that have been given the diagnosis of Neonatal Injury  Educate coders on what constitutes a birth injury  Example: Infant has petechiae (not a birth injury) – this gets coded as Other birth injury  Encourage physicians to document clearly birth injuries  Example: instead of charting Mongolian spots chart normal finding of Mongolian spots What can be done?

PSI-17

 Has anyone reviewed cases and found errors?  What do you think can be done to lower the rate? Sharing

 Next meeting: August 27 th 11:00-11:30  No meeting in September Questions?