Assess whether to escalate a case to peer review (c97cac)

SITUATION After three weekend deaths that look similar on first read, length-of-stay outliers versus DRG peers is what quality-improvement physician can touch in a unit with a new early-warning model. Healthcare will live with Proceed under protocol versus Pause the pathway on this Outcomes Review file.

DECISION Quality-improvement physician in a unit with a new early-warning model must choose Proceed under protocol / Pause the pathway / Escalate safety review / Hold using length-of-stay outliers versus DRG peers after three weekend deaths that look similar on first read.

HYPOTHESES TO TEST 1. Authorize Proceed under protocol now; length-of-stay outliers versus DRG peers already has the discriminator after three weekend deaths that look similar on first read. 2. Keep Pause the pathway in force until length-of-stay outliers versus DRG peers is completed after three weekend deaths that look similar on first read for quality-improvement physician. 3. Treat length-of-stay outliers versus DRG peers as Escalate safety review because both readings appear after three weekend deaths that look similar on first read. 4. Refuse a Healthcare close: quality-improvement physician does not have the decision to escalate a case to peer review turns on in length-of-stay outliers versus DRG peers.

ANALYSIS REQUIRED 1. Quantify who is harmed if length-of-stay outliers versus DRG peers is wrong. 2. Separate a documented exception from an OCR-relevant gap in a unit with a new early-warning model. 3. Validate clinical-outcome evidence and protocol steps in length-of-stay outliers versus DRG peers after three weekend deaths that look similar on first read. 4. For this Healthcare Outcomes Review file, read length-of-stay outliers versus DRG peers against three weekend deaths that look similar on first read and write the one fact that would move to escalate a case to peer review for quality-improvement physician.

RECOMMENDATION Choose Proceed under protocol / Pause the pathway / Escalate safety review / Hold on this Healthcare / Outcomes Review packet (length-of-stay outliers versus DRG peers after three weekend deaths that look similar on first read). The follow-on Outcomes Review action is what quality-improvement physician does next: implement the option, assign an owner, and log the missing fact.

COMMAND RETURNS - Bottom-line Healthcare option on to escalate a case to peer review, then the evidence in length-of-stay outliers versus DRG peers, then the action for quality-improvement physician - Hypothesis scorecard against length-of-stay outliers versus DRG peers: supported / rejected / untestable - Outcomes Review finding in length-of-stay outliers versus DRG peers that a second reviewer can re-perform - Missing page in length-of-stay outliers versus DRG peers after three weekend deaths that look similar on first read, if any