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Chart-Abstracted Error Messages

The Joint Commission

Chart-Abstracted Error Messages

Owned by Patty Craig
Last updated: Jul 10, 2024 by Kelly C
7 min read

Purpose:  

Included below are the various error messages which may be generated on the Chart-Abstracted Data Entry page when edits are executed. The edits do not run “real-time”, instead they will run when the “Submit” button is clicked.

If an edit error was found,” Month – Errors” will show on the top of the month that had an error. Scroll down the page to find the error messages, correct the errors, and click the “Submit” button to reprocess the data against the edits.

If no error is found, “Month – Saved” will show on the top of the month and the quarter will revert to the “Edit” button.

Chart-Abstracted Error Messages:

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: IMM-2; OP-23; PC-01, 02, 05, 06; SUB-2, 3; TOB-3; VTE-6

  • Edit Information: Denominator must be <= Hospital Sample Size

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: HBIPS-2, 3 (all strata)

  • Edit Information: Denominator must be <= (Hospital Sample Size * 24)

  • Fields (type of measure): Hospital Sample Size (all)

  • Measures: ED-1, 2; IMM-2; OP-18; OP-23; PC-01, 02, 05; SUB-2, 3; TOB-3

  • Edit Information:

    • All measures: If Quarterly Sampling Frequency = "monthly" or "quarterly", then Hospital Sample Size cannot be > Initial Population

    • All measures: If Quarterly Sampling Frequency = " Not Sampling", then Hospital Sample Size must be = Initial Population

  • Fields (type of measure): Minimum Observation (CV)

  • Measures: ED-1,2 (all strata); OP-18 (all strata)

  • Edit Information: Minimum Observation must be <= Mean Observation

  • Fields (type of measure): Minimum Observation (CV)

  • Measures: ED-1,2 (all strata); OP-18 (all strata)

  • Edit Information: Minimum Observation must be <= Median Observation

  • Fields (type of measure): Mean Observation (CV)

  • Measures: ED-1,2 (all strata); OP-18 (all strata)

  • Edit Information: Mean Observation must be <= Maximum Observation

  • Fields (type of measure): Median Observation (CV)

  • Measures: ED-1,2 (all strata); OP-18 (all strata)

  • Edit Information: Median Observation must be <= Maximum Observation

  • Fields (type of measure): Number of Unique Patients within the Numerator (ratio only)

  • Measures: HBIPS-2, 3 (all strata)

  • Edit Information: Number of Unique Patients within the Numerator must be <= Hospital Sample Size

NOTE: This edit is a 'fuzzy' edit and will only capture obvious data entry/mistyping. It is comparing patients to hours, so the number of patients can never be > the sum of the hours the patients had with the event.

  • Fields (type of measure): Numerator (proportion/ratio)

  • Measures: HBIPS- 2, 3, (all strata); IMM-2; OP-23; PC-01, 02, 05; PC-06 (all strata); SUB-2, 3 (all strata); TOB-3 (all strata); VTE-6

  • Additional Edit Information:

    • HBIPS-2, 3; IMM-2; OP-23; PC-01, 02, 05; VTE-6: Numerator must be <= Denominator

    • PC-06:

      • Moderate Numerator must be <= Denominator

      • Severe Numerator must be <= Denominator

    • SUB-2:

      • Numerator SUB-2 must be <= Denominator

      • Numerator SUB-2a must be <= Denominator

      • Numerator SUB-2a must be <= SUB-2 Numerator

    • SUB-3:

      • Numerator SUB-3 must be <= Denominator

      • Numerator SUB-3a must be <= Denominator

      • Numerator SUB-3a must be <= SUB-3 Numerator

    • TOB-3:

      • Numerator TOB-3 must be <= Denominator

      • Numerator TOB-3a must be <= Denominator

      • Numerator TOB-3a must be <= TOB-3 Numerator

  • Fields (type of measure): Total Exclusion Count (all)

  • Measures: ED-1, 2; HBIPS-2, 3; IMM-2; OP-18; OP-23; PC-01, 02, 05, 06; SUB-2, 3; TOB-3; VTE-6

  • Edit Information:

    • HBIPS-2, 3; IMM-2; OP-23; PC-01, 02, 05, 06; SUB-2, 3; TOB-3; VTE-6: Total Exclusion Count cannot be > (Hospital Sample Size - Denominator)

    • ED-1, 2;: Total Exclusion Count cannot be > (Hospital Sample Size - Overall Population)

    • OP-18: Total Exclusion Count cannot be > (Hospital Sample Size)

  • Fields (type of measure): Population (CV)

  • Measures: ED-1,2 (all strata); OP-18 (all strata)

  • Edit Information: Population must be <= Hospital Sample Size

  • Fields (type of measure): Standard Deviation of the Observation (CV)

  • Measures: ED-1,2 (all strata); OP-18 (all strata)

  • Edit Information: If Population = 1, then the Standard Deviation of the Observation cannot be entered

  • Fields (type of measure): Initial Population (all); Hospital Sample Size (all); Denominator (proportion/ratio), Measure Exclusion questions (all); Numerator (proportion measures only); Number of Unique Patients in Numerator (ratio); Population (CV); Minimum Observation (CV);  Maximum Observation (CV)

  • Measures: ED-1, 2 (all strata); HBIPS-2, 3 (all strata - does not include the Numerator field); IMM-2; OP-18 (all strata); OP-23; PC-01, 02, 05; PC-06 (all strata); SUB-2, 3 (all strata);
    TOB-3 (all strata); VTE-6

  • Edit Information: Fields are defined as integer, meaning they do not allow decimal places or alphanumeric characters

  • Fields (type of measure): Median Observation (CV); Mean Observation (CV); Standard Deviation of the Observation (CV); Numerator (ratio measures only);

  • Measures: ED-1, 2 (all strata); HBIPS-2, 3 (all strata); OP-18 (all strata)

  • Edit Information: Fields are defined as decimal, meaning they do not allow alphanumeric characters.

  • Fields (type of measure): Initial Population (all); Denominator (proportion/ratio); Measure Exclusion questions (all); Numerator (proportion measures only); Number of Unique Patients in Numerator (ratio); Population (CV); Minimum Observation (CV);  Maximum Observation (CV)

  • Measures: ED-1, 2 (all strata); HBIPS-2, 3 (all strata); IMM-2; OP-18 (all strata); OP-23; PC-01, 02, 05; PC-06 (all strata); SUB-2, 3 (all strata); TOB-3 (all strata); VTE-6

  • Edit Information: Fields may contain values integer numbers from zero (0) to 10,000,000

  • Fields (type of measure): Median Observation (CV); Mean Observation (CV); Standard Deviation of the Observation (CV); Numerator (ratio measures only)

  • Measures: ED-1, 2 (all strata); HBIPS-2, 3 (all strata); OP-18 (all strata)

  • Edit Information: Fields may contain values decimal numbers from zero (0) to 10,000,000.000

  • Fields (type of measure): Hospital Sample Size (all)

  • Measures: ED-1, 2; IMM-2; OP-18; OP-23; PC-01, 02, 05; SUB-2, 3; TOB-3

  • Edit Information: Field may contain values integer numbers from 1 to 10,000,000

  • Fields (type of measure): Numerator (proportion/ratio)

  • Measures: PC-06; SUB-2, 3; TOB-3

  • Edit Information:

    • PC-06: (Severe Numerator + Moderate Numerator) must be <= Denominator

    • SUB-2: Numerator SUB-2 must be <= Denominator

    • SUB-3: Numerator SUB-3 must be <= Denominator

    • TOB-3: Numerator TOB-3 must be <= Denominator

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: HBIPS-2a, 3a (only these strata)

  • Additional Edit Information:

    • HBIPS-2a: Denominator must = the sum of the Denominator for (HBIPS-2b + HBIPS-2c + HBIPS-2d + HBIPS-2e)

    • HBIPS-3a: Denominator must = the sum of the Denominator for (HBIPS-3b + HBIPS-3c + HBIPS-3d + HBIPS-3e)

  • Fields (type of measure): Initial Population (all)

  • Measures: HBIPS-2a, 3a (only these strata)

  • Edit Information:

    • HBIPS-2a: Initial Population Overall must = the sum of the Initial Population for (HBIPS-2b + HBIPS-2c + HBIPS-2d + HBIPS-2e)

    • HBIPS-3a: Initial Population Overall must = the sum of the Initial Population for (HBIPS-3b + HBIPS-3c + HBIPS-3d + HBIPS-3e)

  • Fields (type of measure): Maximum Observation (CV)

  • Measures: ED-1a, 2a (only these strata)

  • Edit Information:

    • ED-1a: Maximum Observation Overall = the higher of Maximum ED-1b or Maximum ED-1c

    • ED-2a: Maximum Observation Overall = the higher of Maximum ED-2b or Maximum ED-2c

  • Fields (type of measure): Minimum Observation (CV)

  • Measures: ED-1a, 2a (only these strata)

  • Edit Information:

    • ED-1a: Minimum Observation Overall = the lower of Minimum ED-1b or Minimum ED-1c

    • ED-2a: Minimum Observation Overall = the lower of Minimum ED-2b or Minimum ED-2c

  • Fields (type of measure): Number of Unique Patients within the Numerator (ratio only)

  • Measures: HBIPS-2a, 3a (only these strata)

  • Edit Information:

    • HBIPS-2a: Number of Unique Patients Overall must = the sum of the Number of Unique Patients for (HBIPS-2b + HBIPS-2c + HBIPS-2d + HBIPS-2e)

    • HBIPS-3a: Number of Unique Patients Overall must = the sum of the Number of Unique Patients for (HBIPS-3b + HBIPS-3c + HBIPS-3d + HBIPS-3e)

  • Fields (type of measure): Numerator (proportion/ratio)

  • Measures: HBIPS-2a, 3a (only these strata)

  • Edit Information:

    • HBIPS-2a: Numerator Overall must = the sum of the Numerator for (HBIPS-2b + HBIPS-2c + HBIPS-2d + HBIPS-2e)

    • HBIPS-3a: Numerator Overall must = the sum of the Numerator for (HBIPS-3b + HBIPS-3c + HBIPS-3d + HBIPS-3e)

  • Fields (type of measure): Population (CV)

  • Measures: ED-1a, 2a (only these strata)

  • Edit Information:

    • ED-1a: Population Overall must = the sum of the Population for (ED-1b + ED-1c)

    • ED-2a: Population Overall must = the sum of the Population for (ED-2b + ED-2c)

  • Fields (type of measure): Total Count of Cases with Category Y or X (all)

  • Measures: ED-1, 2; IMM-2; OP-23; PC-01, 02, 05, 06; SUB-2, 3; TOB-3; VTE-6

  • Edit Information:

    • Total Count of Cases with Category Y or X cannot be > (Hospital Sample Size - Total Exclusion Count - Denominator)

  • Fields (type of measure): Attestation checkbox (Initial Population, Population, Denominator)

  • Measures: ALC-01, 02, 03, 04, 05; ED-1, 2; HBIPS-2, 3 (all strata); IMM-2; OP-18; OP-23; PC-01, 02, 05, 06; SUB-2, 3; TOB- 3; VTE-6

  • Edit Information:

    • If Initial Population = 0, then

      • Zero Initial Population Case Attestation must be checked.

    • If Population = 0, then

      • Zero Population Case Attestation must be checked

    • If Denominator = 0, then

      • Zero Denominator Case Attestation must be checked

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-05a

  • Edit Information: Value must be an integer within 0 to 199 and less than or equal to the Number of Staff Employed

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-05b

  • Edit Information: Value must be an integer within 0 to 199 and less than or equal to the Number of Direct Staff Employed

  • Fields (type of measure): Numerator (proportion/ratio)

  • Measures: ALC-01, ALC-02, ALC-03, ALC-04

  • Edit Information: Value must be an integer within 0 to 199 and less than or equal to the Denominator

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-05a

  • Edit Information: Number of Staff Employed minus Number of Positions or employees on the last day of month, and cannot be less than 0

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-05b

  • Edit Information: Value is the result of: Number of Direct Care Staff Employed minus number of direct care positions or employees on the last day of month, and cannot be less than 0

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-05a

  • Edit Information: Value must be an integer within 0 to 199

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-05b

  • Edit Information: Value must be an integer within 0 to 199 and less than or equal to the Number of Staff Employed

  • Fields (type of measure): Denominator (proportion/ratio)

  • Measures: ALC-01, ALC-02, ALC-03, ALC-04

  • Edit Information: Value must be an integer within 0 to 199

Continue to the next section: Chart-Abstracted Measure List

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