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## Complete Summary

#### TITLE

Obstetrics: percentage of inborn term babies transferred/admitted to a
neonatal intensive care nursery or special care nursery for reasons
other than congenital abnormality.

#### SOURCE(S)

Australian Council on Healthcare Standards (ACHS). ACHS clinical
indicator users\' manual 2008. ULTIMO NSW: Australian Council on
Healthcare Standards (ACHS); 2007 Dec. 776 p.

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Use of Services

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of inborn term babies
transferred/admitted to a neonatal intensive care nursery or special
care nursery for reasons other than congenital abnormality.

#### RATIONALE

This indicator is included to determine whether the rate of admission of
inborn term infants to special care nursery (SCN) or neonatal intensive
care nursery (NICN) for reasons other than birth defects is principally
due to non-avoidable factors. Inborn term infants without birth defects
are not normally expected to be admitted to a SCN or NICN.

The indicator focuses on all admissions of term infants (without a birth
defect), resulting from adverse events occurring in labour or immediate
neonatal period, which require the facilities of SCN or NICN. This will
include, but is not limited to term infants with:

-   Low five-minute Apgar scores

-   Birth trauma

-   Early seizures/hypoxic ischaemic encephalopathy (HIE)

-   Intrauterine growth restriction (IUGR)

-   Sepsis

#### PRIMARY CLINICAL COMPONENT

Obstetrics; inborn term live babies; neonatal intensive care nursery
(NICN); special care nursery (SCN)

#### DENOMINATOR DESCRIPTION

Total number of inborn term live babies (see the related \"Denominator
Inclusions/Exclusions\" field in the Complete Summary)

#### NUMERATOR DESCRIPTION

Total number of inborn term babies transferred/admitted to a neonatal
intensive care nursery (NICN) or special care nursery (SCN) for reasons
other than congenital abnormality (see the related \"Numerator
Inclusions/Exclusions\" field in the Complete Summary)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE VALUE OF MONITORING USE OF SERVICE

-   A formal consensus procedure involving experts in relevant clinical,
    methodological, and organizational sciences

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Monitoring and planning

#### EVIDENCE SUPPORTING NEED FOR THE MEASURE

Australian Council on Healthcare Standards (ACHS). Australian clinical
indicator report 1998-2006. Determining the potential to improve quality
of care: 8th edition. ULTIMO NSW: Australian Council on Healthcare
Standards (ACHS); 2007. 564 p.

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Monitoring and planning

### Application of Measure in its Current Use

#### CARE SETTING

Hospitals

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Single Health Care Delivery Organizations

#### TARGET POPULATION AGE

Unspecified

#### TARGET POPULATION GENDER

Female (only)

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Not within an IOM Care Need

#### IOM DOMAIN

Not within an IOM Domain

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Inborn term live babies

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of inborn\* term\*\* live babies

\*Inborn baby is defined as an infant born at the reporting hospital.

\*\*Term refers to gestation of equal to or greater than 37 weeks
gestation.

Refer to the original measure documentation for the specific
International Classification of Diseases, Tenth Revision, Australian
Modification (ICD-10-AM) codes.

**Exclusions**\
Refer to the original measure documentation for the specific ICD-10-AM
codes to be excluded.

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are not equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Institutionalization\
Therapeutic Intervention

#### DENOMINATOR TIME WINDOW

Time window is a single point in time

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of inborn term babies transferred/admitted to a neonatal
intensive care nursery (NICN)\* or special care nursery (SCN)\*\* for
reasons other than congenital abnormality

\*Neonatal intensive care nurseries are staffed and equipped to treat
critically ill newborn babies including those requiring prolonged
assisted respiratory support, intravenous therapy, and alimentation and
treatment of serious infections. Full supportive services are readily
available throughout the hospital. These NICN also provide consultative
services to other hospitals.

\*\*Special care nurseries are staffed and equipped to provide a full
range of neonatal services for the majority of complicated neonatal
problems, including short-term assisted ventilation and intravenous
therapy.

**Note**: The intent of this indicator is to measure the standards of
care of the treating hospital/O&G and therefore:

-   Admissions/transfers to a SCN or NICN within the treating
    (reporting) hospital should be included in the numerator.

-   Transfers (from the reporting hospital) to a SCN or NICN in another
    hospital should be included in the numerator of the reporting
    hospital.

-   The receiving hospital should not include transfers from another
    hospital in this indicator.

**Exclusions**\
Admissions due to congenital abnormality are excluded. Clarification
from clinicians should be sought if difficulty is encountered in
determining congenital abnormality.

Refer to the original measure documentation for specific International
Classification of Diseases, Tenth Revision, Australian Modification
(ICD-10-AM) codes to be excluded.

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Institutionalization

#### DATA SOURCE

Administrative data\
Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Does not apply to this measure

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Undetermined

#### ALLOWANCE FOR PATIENT FACTORS

Unspecified

#### STANDARD OF COMPARISON

External comparison at a point in time\
External comparison of time trends\
Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Indicator area 10: all admissions of a term baby to special care nursery
or neonatal intensive care nursery CI 10.1.

#### MEASURE COLLECTION

[Australian Council on Healthcare Standards (ACHS) Equip Clinical
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1984&doc=11061)

#### MEASURE SET NAME

[Obstetrics
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1984&doc=11725)

#### DEVELOPER

Australian Council on Healthcare Standards

#### FUNDING SOURCE(S)

Funding is direct Australian Council on Healthcare Standards (ACHS)
funding sourced through our membership. ACHS does not receive external
funding from the government or other sources.

#### COMPOSITION OF THE GROUP THAT DEVELOPED THE MEASURE

Our terms of reference dictate the composition of the working parties
that develop our indicators and include the following:

-   Two Clinicians \-- nominated by the relevant specialty
    college/association/society, one nominated to be the chair of the
    working party

-   Private Hospital Representative \-- nominated by the Australian
    Private Hospital Association

-   Consumer Representative \-- nominated by the Consumer Health Forum
    of Australia

-   Coding Representative \-- nominated by the National Centre for
    Clinical classification on Health

-   Quality Health New Zealand, nominated by QHNZ (if applicable)

-   Epidemiological/Clinical Research Representative, Director of Health
    Services Research Group, University of Newcastle

-   Australian Council on Healthcare Standards (ACHS) Representatives
    \-- Clinical Director, Coordinator, Administrative Assistant

-   Other Expert Stakeholders, as required

#### FINANCIAL DISCLOSURES/OTHER POTENTIAL CONFLICTS OF INTEREST

None

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

1995 Jan

#### REVISION DATE

2008 May

#### MEASURE STATUS

This is the current release of the measure.

#### SOURCE(S)

Australian Council on Healthcare Standards (ACHS). ACHS clinical
indicator users\' manual 2008. ULTIMO NSW: Australian Council on
Healthcare Standards (ACHS); 2007 Dec. 776 p.

#### MEASURE AVAILABILITY

The individual measure, \"Indicator Area 10: All Admissions of a Term
Baby to Special Care Nursery or Neonatal Intensive Care Nursery CI
10.1,\" is published in \"ACHS Clinical Indicator Users\' Manual 2008.\"

For more information contact, the Australian Council on Healthcare
Standards (ACHS), 5 Macarthur Street, ULTIMO NSW 2007; Phone: (02) 9281
9955; Fax: (02) 9211 9633; E-mail: <pos@achs.org.au>; Web site:
[www.achs.org.au](http://www.achs.org.au/).

#### COMPANION DOCUMENTS

The following is available:

-   Australian Council on Healthcare Standards (ACHS). Australian
    clinical indicator report 1998-2006. Determining the potential to
    improve quality of care: 8th edition. ULTIMO NSW: Australian Council
    on Healthcare Standards (ACHS); 2007. 564 p. This document is
    available in Portable Document Format (PDF) from the [Australian
    Council on Healthcare Standards (ACHS) Web
    site](http://www.achs.org.au/pdf/Australasian_CIR_8th_Edition.pdf).

#### NQMC STATUS

This NQMC summary was completed by ECRI Institute on October 21, 2008.

#### COPYRIGHT STATEMENT

This NQMC summary is based on the original measure, which is subject to
the measure developer\'s copyright restrictions. This work is copyright.
Apart from any use as permitted under the Copyright Act 1968, no part
may be reproduced by any process without written permission from The
Australian Council on Healthcare Standards (ACHS).

### Disclaimer

#### NQMC DISCLAIMER

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/10/2008