Harbor:Interqual Criteria Tips - Revision history

Bchap23 at 19:59, 18 July 2022

2022-07-18T19:59:37Z

← Older revision		Revision as of 19:59, 18 July 2022
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	* '''ADULT Interqual admission criteria'''		* '''ADULT Interqual admission criteria'''
	** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]		** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]
	** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)		** '''Admitting for WORK-UP will never meet''' (be creative, talk to UR, and find an actual admission diagnosis)
	** Ever wonder why you need an override note? Here are some top diagnoses and what makes them meet for admission		** Ever wonder why you need an override note? Here are some top diagnoses and what makes them meet for admission
	*** We don't have obs status, which is why override notes are needed		*** We don't have obs status, which is why override notes are needed

Andreawu at 19:30, 23 May 2022

2022-05-23T19:30:41Z

← Older revision		Revision as of 19:30, 23 May 2022
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			* For PEDIATRIC Interqual admission criteria, see below
	* '''ADULT Interqual admission criteria'''		* '''ADULT Interqual admission criteria'''
	** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]		** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]

Andreawu at 19:29, 23 May 2022

2022-05-23T19:29:04Z

@@ Line 20: / Line 20: @@
 **** ≥ 2 doses albuterol AND
 **** Hypoxia or signif abnl blood gas: 02 sat ≤ 89% OR PaO2 ≤ 55 mmHg and pH > 7.45 OR Pco2 > 45 mmHg and pH < 7.35 OR
 **** Increased work of breathing OR cyanosis OR risk factor (e.g., cor pulmonale, cancer, pneumonia, DM, home O2, Class III or IV HF, mental illness, substance use disorder, stable angina)
 *** '''DVT''': continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned
@@ Line 75: / Line 73: @@
 *'''PEDIATRIC Interqual admission criteria'''
 ** See helpful document [[:File:interqual_admission_guide_checklist_pediatrics2021.pdf]]
 [[Category:Admin]]

Andreawu at 18:51, 23 May 2022

2022-05-23T18:51:42Z

← Older revision		Revision as of 18:51, 23 May 2022
Line 1:		Line 1:
	* '''ADULT Interqual criteria'''		* '''ADULT Interqual admission criteria'''
	** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]		** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]
	** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)		** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)
Line 20:		Line 20:
	**** ≥ 2 doses albuterol AND		**** ≥ 2 doses albuterol AND
	**** Hypoxia or signif abnl blood gas: 02 sat ≤ 89% OR PaO2 ≤ 55 mmHg and pH > 7.45 OR Pco2 > 45 mmHg and pH < 7.35 OR		**** Hypoxia or signif abnl blood gas: 02 sat ≤ 89% OR PaO2 ≤ 55 mmHg and pH > 7.45 OR Pco2 > 45 mmHg and pH < 7.35 OR

			*
	**** Increased work of breathing OR cyanosis OR risk factor (e.g., cor pulmonale, cancer, pneumonia, DM, home O2, Class III or IV HF, mental illness, substance use disorder, stable angina)		**** Increased work of breathing OR cyanosis OR risk factor (e.g., cor pulmonale, cancer, pneumonia, DM, home O2, Class III or IV HF, mental illness, substance use disorder, stable angina)
	*** '''DVT''': continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned		*** '''DVT''': continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned
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	*** '''TIA'''		*** '''TIA'''
	**** Neuro deficit resolved/resolving AND crescendo TIA OR endocardial vegetation OR previous stroke		**** Neuro deficit resolved/resolving AND crescendo TIA OR endocardial vegetation OR previous stroke

			*'''PEDIATRIC Interqual admission criteria'''
			** See helpful document [[:File:interqual_admission_guide_checklist_pediatrics2021.pdf]]

	[[Category:Admin]]		[[Category:Admin]]

Andreawu at 18:45, 23 May 2022

2022-05-23T18:45:47Z

← Older revision		Revision as of 18:45, 23 May 2022
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	* '''Interqual criteria'''		* '''ADULT Interqual criteria'''
	** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]		** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]
	** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)		** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)

Andreawu at 18:42, 23 May 2022

2022-05-23T18:42:42Z

← Older revision		Revision as of 18:42, 23 May 2022
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	*** We don't have obs status, which is why override notes are needed		*** We don't have obs status, which is why override notes are needed
	*** Abdominal pain - will not meet (only obs)		*** Abdominal pain - will not meet (only obs)
	*** Chest Pain - STEMI, NSTEMI, or suspected ACS with		*** '''Chest Pain''' - STEMI, NSTEMI, or suspected ACS with
	**** new LBBB,		**** new LBBB,
	**** unstable angina and IV NTG, or		**** unstable angina and IV NTG, or
	**** 2 or more doses of morphine		**** 2 or more doses of morphine
	*** Anaphylaxis - inhaler Q2 hours, impending intubation or on BiPAP		*** '''Anaphylaxis''' - inhaler Q2 hours, impending intubation or on BiPAP
	*** Anemia - only for symptomatic hemolytic anemia with Hgb <10 AND		*** '''Anemia''' - only for symptomatic hemolytic anemia with Hgb <10 AND
	**** Hgb q12 hrs with transfusion or		**** Hgb q12 hrs with transfusion or
	**** steroids, immunotherapy, or immunoglobin		**** steroids, immunotherapy, or immunoglobin
	*** A-fib/flutter: Requiring continuous antiarrhythmic/digoxin loading/permanent pacemaker OR		*** '''A-fib/flutter''': Requiring continuous antiarrhythmic/digoxin loading/permanent pacemaker OR
	*** Asthma: Impending respiratory failure, mechanical ventilation, NIPPV, status asthmaticus, PEF/FEV1 < 40% after 2h treatment in ED, PEF/FEV1 ≤ 25%, use of accessory muscles, MS changes/drowsiness, albuterol q1-2h continuous		*** '''Asthma''': Impending respiratory failure, mechanical ventilation, NIPPV, status asthmaticus, PEF/FEV1 < 40% after 2h treatment in ED, PEF/FEV1 ≤ 25%, use of accessory muscles, MS changes/drowsiness, albuterol q1-2h continuous
	*** Cellulitis: Immunocompromised OR located over a prosthesis/implanted device OR orbital		*** '''Cellulitis''': Immunocompromised OR located over a prosthesis/implanted device OR orbital
	*** COPD exacerbation:		*** '''COPD exacerbation''':
	**** Impending intubation OR NIPPV OR mechanical ventilation OR dyspnea AND		**** Impending intubation OR NIPPV OR mechanical ventilation OR dyspnea AND
	**** ≥ 2 doses albuterol AND		**** ≥ 2 doses albuterol AND
	**** Hypoxia or signif abnl blood gas: 02 sat ≤ 89% OR PaO2 ≤ 55 mmHg and pH > 7.45 OR Pco2 > 45 mmHg and pH < 7.35 OR		**** Hypoxia or signif abnl blood gas: 02 sat ≤ 89% OR PaO2 ≤ 55 mmHg and pH > 7.45 OR Pco2 > 45 mmHg and pH < 7.35 OR
	**** Increased work of breathing OR cyanosis OR risk factor (e.g., cor pulmonale, cancer, pneumonia, DM, home O2, Class III or IV HF, mental illness, substance use disorder, stable angina)		**** Increased work of breathing OR cyanosis OR risk factor (e.g., cor pulmonale, cancer, pneumonia, DM, home O2, Class III or IV HF, mental illness, substance use disorder, stable angina)
	*** DVT: continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned		*** '''DVT''': continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned
	*** DKA: BS > 250 mg/dL AND ketones elevated AND anion gap >12 mEq/L OR pH <7.25 serum OR HCO3 or CO2 < 15 mEq/L		*** '''DKA''': BS > 250 mg/dL AND ketones elevated AND anion gap >12 mEq/L OR pH <7.25 serum OR HCO3 or CO2 < 15 mEq/L
	*** Gastroenteritis/Dehydration: only meets obs criteria, consider another primary diagnosis		*** '''Gastroenteritis/Dehydration''': only meets obs criteria, consider another primary diagnosis
	*** GI Bleed:		*** '''GI Bleed''':
	**** 1L IVF or blood product transfusion prior to decision to admit AND		**** 1L IVF or blood product transfusion prior to decision to admit AND
	**** Hct < 21%/Hb < 7 g/dL OR		**** Hct < 21%/Hb < 7 g/dL OR
	**** Exertional dyspnea OR MS changes OR		**** Exertional dyspnea OR MS changes OR
	**** INR ≥ 2 OR orthostatic hypotension OR presyncope/syncope		**** INR ≥ 2 OR orthostatic hypotension OR presyncope/syncope
	*** Heart Failure:		*** '''Heart Failure''':
	**** New onset symptoms AND rales, gallop, OR pleural effusion/pulmonary edema/cardiomegaly on CXR, OR edema, hepatomegaly, JVD OR BNP or NT-pro-BNP > ULN OR		**** New onset symptoms AND rales, gallop, OR pleural effusion/pulmonary edema/cardiomegaly on CXR, OR edema, hepatomegaly, JVD OR BNP or NT-pro-BNP > ULN OR
	**** Acute on chronic AND O2 sat < 89% after ≥ 1 diuretic dose and ≥ 2h treatment AND		**** Acute on chronic AND O2 sat < 89% after ≥ 1 diuretic dose and ≥ 2h treatment AND
	**** Inadequate diuresis, troponin > ULN, Cr > 1.5x baseline, CKD (excludes dialysis) and Cr ≥ 2.75 mg/dL OR HR 100-120/min OR SBP ≤ 120 mmHg OR Na < 130 mEQ/L OR BUN > 43 mg/dL OR mental illness/cognitive impairment/substance use disorder OR		**** Inadequate diuresis, troponin > ULN, Cr > 1.5x baseline, CKD (excludes dialysis) and Cr ≥ 2.75 mg/dL OR HR 100-120/min OR SBP ≤ 120 mmHg OR Na < 130 mEQ/L OR BUN > 43 mg/dL OR mental illness/cognitive impairment/substance use disorder OR
	**** Dyspnea not returned to baseline after 1 dose of diuretic and ≥ 2h treatment		**** Dyspnea not returned to baseline after 1 dose of diuretic and ≥ 2h treatment
	*** HTN		*** '''HTN''':
	*** Migraine		**** End organ damage AND
	*** Nephrolithiasis		**** hematuria OR proteinuria OR aortic aneurysm/dissection OR CHF OR encephalopathy/MS change OR papilledema/retinal hemorrhage/vision changes OR seizure
	*** Hypoglycemia		**** Pregnancy with HELLP OR preeclampsia OR SBP >/= 160, DBP >/= 110 after anti HTN med
	*** Pneumonia		*** '''Migraine''':
	*** PE		**** only meets obs criteria, consider another primary diagnosis
	*** Pyelonephritis		*** '''Nephrolithiasis''':
	*** Sickle Cell		**** Obstruction by imaging AND nephrostomy planned OR
	*** Stroke		**** Urinary catheterization necessary and Cr >1.8
	*** Syncope		*** '''Hypoglycemia''':
	*** TIA		**** Gluc < 70 AND AMS OR Seizure
			*** '''Pneumonia''':
			**** Impending intubation/vent dependent OR NIPPV OR
			**** Pressors OR
			**** O2Sat < 89% OR PaO2 < 56 OR PCO2 >/= 45 and pH >/= 7.31 OR
			**** Empyema, or lung abscess or necrotizing
			**** 2 or more lobes OR
			**** Pneumonia severity index >/= 91 OR 3 or more CURB 65 criteria OR
			*** '''PE''':
			**** Impending intubation/vent dependent OR NIPPV OR
			**** PE by imaging AND anticaog AND hypoxia </= 90%, and requiring supplmental O2 OR
			**** HIT OR HF requiring IV diuresis or titration of oral diuretic OR bridging AC OR IVC filter placement OR Continuous UFH OR
			**** abnormal biomarkers OR RV dysfxn OR pressors OR lytics
			*** '''Pyelonephritis/UTI''': SIRS AND UCx pending AND
			**** Urinary symptoms AND abnormal UA AND systemic infection or end organ compromise (+BCx, or >/= 24 weeks pregnant, or urinary stent/UTI obstruction, or organ dysfunction or hypoperfusion) A
			*** '''Sickle Cell'''
			**** Acute pain requiring IVF and IV analgesics >/=4x OR
			**** Acute chest syndrome and anti-infective OR
			**** Aplastic crisis requiring IVF OR transfusion and lab monitoring
			**** Fever >/= 38.5 AND anti-infective
			*** '''Stroke'''
			**** Acute ischemic OR hemorrhagic stroke
			*** '''Syncope'''
			**** only meets obs criteria, consider another primary diagnosis (arrythmia, anemia, GIB, etc.)
			*** '''TIA'''
			**** Neuro deficit resolved/resolving AND crescendo TIA OR endocardial vegetation OR previous stroke

	[[Category:Admin]]		[[Category:Admin]]

Andreawu at 05:05, 21 March 2022

2022-03-21T05:05:46Z

← Older revision		Revision as of 05:05, 21 March 2022
Line 1:		Line 1:
	* '''Interqual criteria'''		* '''Interqual criteria'''
	** See helpful document [[:File:InterQual admission guide checklist adult2021]]		** See helpful document [[:File:InterQual admission guide checklist adult2021.pdf]]
	** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)		** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)
	** Ever wonder why you need an override note? Here are some top diagnoses and what makes them meet for admission		** Ever wonder why you need an override note? Here are some top diagnoses and what makes them meet for admission

Andreawu at 05:03, 21 March 2022

2022-03-21T05:03:42Z

← Older revision		Revision as of 05:03, 21 March 2022
Line 45:		Line 45:
	*** Syncope		*** Syncope
	*** TIA		*** TIA

			[[Category:Admin]]

Andreawu at 22:19, 19 March 2022

2022-03-19T22:19:26Z

← Older revision		Revision as of 22:19, 19 March 2022
Line 23:		Line 23:
	*** DVT: continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned		*** DVT: continuous unfractionated heparin AND risk of limb compromise and anticoagulation OR hospital acquired and initiation of anticoagulation OR IVC filter placement planned
	*** DKA: BS > 250 mg/dL AND ketones elevated AND anion gap >12 mEq/L OR pH <7.25 serum OR HCO3 or CO2 < 15 mEq/L		*** DKA: BS > 250 mg/dL AND ketones elevated AND anion gap >12 mEq/L OR pH <7.25 serum OR HCO3 or CO2 < 15 mEq/L
	*** Gastroenteritis/Dehydration: only meets obs criteria, consider another ~~main~~ diagnosis		*** Gastroenteritis/Dehydration: only meets obs criteria, consider another primary diagnosis
	*** GI Bleed:		*** GI Bleed:
	**** 1L IVF or blood product transfusion prior to decision to admit AND		**** 1L IVF or blood product transfusion prior to decision to admit AND

Andreawu at 22:16, 19 March 2022

2022-03-19T22:16:50Z

← Older revision		Revision as of 22:16, 19 March 2022
Line 1:		Line 1:
	* '''Interqual criteria'''		* '''Interqual criteria'''
	** See helpful document		** See helpful document [[:File:InterQual admission guide checklist adult2021]]
	[[File:InterQual admission guide checklist adult2021~~\|thumb\|InterQual Guide~~]]
	** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)		** Admitting for WORK-UP will never meet (be creative, talk to UR, and find an actual admission diagnosis)
	** Ever wonder why you need an override note? Here are some top diagnoses and what makes them meet for admission		** Ever wonder why you need an override note? Here are some top diagnoses and what makes them meet for admission
Line 30:		Line 29:
	**** Exertional dyspnea OR MS changes OR		**** Exertional dyspnea OR MS changes OR
	**** INR ≥ 2 OR orthostatic hypotension OR presyncope/syncope		**** INR ≥ 2 OR orthostatic hypotension OR presyncope/syncope
	*** ~~CHF~~		*** Heart Failure:
			**** New onset symptoms AND rales, gallop, OR pleural effusion/pulmonary edema/cardiomegaly on CXR, OR edema, hepatomegaly, JVD OR BNP or NT-pro-BNP > ULN OR
			**** Acute on chronic AND O2 sat < 89% after ≥ 1 diuretic dose and ≥ 2h treatment AND
			**** Inadequate diuresis, troponin > ULN, Cr > 1.5x baseline, CKD (excludes dialysis) and Cr ≥ 2.75 mg/dL OR HR 100-120/min OR SBP ≤ 120 mmHg OR Na < 130 mEQ/L OR BUN > 43 mg/dL OR mental illness/cognitive impairment/substance use disorder OR
			**** Dyspnea not returned to baseline after 1 dose of diuretic and ≥ 2h treatment
	*** HTN		*** HTN
	*** Migraine		*** Migraine