Acute MI

IndicatorDocumentation requirements
ASA within 24 hrs. of hospital arrivalMust document why no ASA unless there is documentation of contraindication or patient currently on warfarin, Xarelto or Pradaxa. Must address this indicator no matter what the time frame of the cardiac event. If AMI occurred during hospitalization but not at admission, documentation must reflect why ASA was not initialed on admission.
LDL within 24 hours of arrivalMust be ordered within 24 hours of Hospital arrival time 
Evaluation of LVS functionSome reference to past echo, recent cardiac cath (if EF evaluated at that time) or narrative description of LV function MUST be documented in current record on every admission.
ACEI/ARB at discharge if EF<40%MUST have a clear documentation for not prescribing ACEI/ARB at discharge. Allergy must be to both ACEI/ARB. Documentation of the following 5 conditions are exclusions for both medications at discharge: angioedema, hyperkalemia, hypotension, renal artery stenosis or worsening renal disease.
Discharge prescriptions: Aspirin, beta-blocker and statinIf any of these medications are not prescribed, explicit rationale must be documented. Statin only needs to be prescribed for LSL greater than 100 OR if patient was on lipid lowering agent previously.