When JHACO refers to allowable values, they are talking about forms that the person who fills out the core measure documentation is using. This may be your QI department? They use specific forms that help them pull the needed data from the chart. The only medical conditions that meet criteria for supplementation so that they can be excluded from data collection are in the list provided in the document from the United States Breastfeeding Committee and JHACO.
http://www.usbreastfeeding.org/Portals/0/Publications/Implementing-TJC-Measure-EBMF-2013-USBC.pdf
They are saying that if the mother's feeding preference of formula is documented in the mothers chart by RN along with the fact that she received education about the benefits of breastfeeding prior than the first feed, you can select #2 on the form, selecting #2 means that you can exclude that infant from your data collection, and you can exclude those infants when there is a documented medical condition #1. Choosing #3 means that is a breastfed infant was supplemented with formula and you have to include them in your stats. So basically if you have documentation, choices #1 and #2 are infants you can exclude from your data collection. Those babies who have an ICD9 code such as premies are already excluded. Then if the baby didn't get excluded by #1 or #2, you put that number of babies in the denominator. You put all the exclusively breastfed babies in the numerator, and then you calculate your percentage.
Tricia Shamblin, RN, IBCLC
Date: Mon, 2 Jun 2014 14:07:56 +0000
From: "Hendrix, Pamela" <[log in to unmask]>
Subject: Allowable values update Joint Commission
Can anyone explain where we can find the allowable values? I am reading the update my manager laid on my desk (she is lost and felt I would know). It says if a newborn medical conditions, i. e., hypoglycemia, weight loss, hyperbilirubinemia, etc , are documented as a reason for not exclusively feeding breast milk, select allowable value 3. Where are these values they are referring to? When I read the original document, on page 5 there are acceptable conditions...but nothing is referred to in "values" that we would "select". The third choice down has nothing to do with hypoglycemia, hyperbilirubinemia, weight loss, etc.
This update was to clarify things? I feel more lost. Anyone have advice? My management team is waiting for my "summary" on what to teach the nurses.
Pamela
S. Florida
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