A review of PQRS Measure #54: EKG for Non-Traumatic Chest Pain.

4. 11 measures
Antibiotic
stewardship
• #66: Pharyngitis patients
given an abx who had
strep test performed
• #91: Patients with Otitis
Externa given a topical abx
• #93: Patients with Otitis
Externa not given a
systemic abx
• #116: 18-64 y/o with
bronchitis not given abx
within 3 days of encounter
ChoosingWisely:
Head CT Utilization
• #416: 2-17 y/o with
appropriate head CT for
blunt head trauma
(PECARN rules)
• #415: 18+ y/o with
appropriate head CT
ordering for blunt head
trauma
Pregnancy
Measures
• #254: US localization of
pregnancy in pregnant
pts with abd pain
• #255: Rhogam for Rh
negative patients at risk
Miscellaneous
• #54: EKG for non-
traumatic chest pain
• #76: Proper sterile
technique for CVC
placement
• #317: BP Screening and
follow up documented

5. #54: EKG for non-
traumatic chest pain
Week 1

6. #54.
Inclusion
1. Patients > 40 years old
2. Diagnosis of Non traumatic chest pain
3. Numerator: All patients satisfying #1
and #2 with EKG done
4. Denominator: All patients > 40 with a
diagnosis of non-Traumatic Chest Pain
seen in an ED

7. #54.
Exclusion
Examples
1. Patient Reason:
• Patient refused EKG
• Patient in cardiac arrest, unable
to perform EKG
2. Medical reason:
• Pain not considered cardiac
• Very few exceptions otherwise

8. Best Practices
Acceptable exclusions:
1. The diagnoses “Muscular Chest Pain”, “Chest Wall Pain” are both acceptable as both
specifically reference the alternate source of pain.
2. The statement “Pain not felt to be cardiac source” is also acceptable.
Not Acceptable:
1. The diagnosis “Atypical chest pain” or other non-specific diagnosis.
2. The statement “Pain is possibly related to cardiac disease, but unlikely.”