Journal excerpt: Understand why PSI 90 CDI reviews matter now

By Cheryl Manchenton, RN, BSN, CCDS

If you search for Patient Safety Indicator (PSI) 90 (Patient Safety and Adverse Events Composite) in the Agency for Healthcare Research and Quality’s (AHRQ) Version 7.0 software released in October 2017, you won’t find it.

PSI-90 is currently suspended.

That’s because the agency is in “data collection mode,” collecting and analyzing ICD-10 data so it can set expected rates for PSI 90, essentially creating an ICD-10 version.

PSIs are a set of measures that screen for complications or adverse events that patients experience as a result of exposure to the healthcare system. AHRQ’s methodology requires a five-year data set to create the modified PSI, and fiscal year (FY) 2018 is the third year of the five-year collection period that will ultimately influence expected rates.

Since AHRQ is busy creating an ICD-10 version of PSI 90, CMS decided to remove this quality measure from its Hospital Value-Based Purchasing (VBP) Program and Hospital-Acquired Condition (HAC) Reduction Program beginning in FY 2019. CMS doesn’t want to penalize hospitals for PSI 90 rates that are rooted in old data (e.g., prior to September 1, 2015), especially because hospitals may have made significant strides in improving patient care since that data was reported.

Does this mean that CDI specialists can sit back and relax, knowing that PSI 90 is excluded from these two CMS programs?

Not exactly.

CMS’ removal of PSI 90 is temporary—not permanent. This means PSI 90 must remain on CDI specialists’ radar. In fact, now is the time to improve data quality and design quality-driven workflows as AHRQ will base expected rates and weights for PSI 90 on the data that organizations collect now.

Organizations can’t change data they have already reported, but they can start making improvements that will affect future payments. Remember, once expected rates are published, it’s too late to fix organizational performance.

That’s why it’s more important than ever to ensure that PSI metrics are complete and accurate.

Editor’s note: To read more about PSI 90 reviews now, read the full article in the September/October edition of the CDI Journal.