Harbor:Interqual Criteria Tips

• Interqual criteria
  • See helpful document

File:InterQual admission guide checklist adult2021

InterQual Guide

• • 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
    • We don't have obs status, which is why override notes are needed
    • Abdominal pain - will not meet (only obs)
    • Chest Pain - STEMI, NSTEMI, or suspected ACS with
      • new LBBB,
      • unstable angina and IV NTG, or
      • 2 or more doses of morphine
    • Anaphylaxis - inhaler Q2 hours, impending intubation or on BiPAP
    • Anemia - only for symptomatic hemolytic anemia with Hgb <10 AND
      • Hgb q12 hrs with transfusion or
      • steroids, immunotherapy, or immunoglobin
    • 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
    • Cellulitis: Immunocompromised OR located over a prosthesis/implanted device OR orbital
    • COPD exacerbation:
      • Impending intubation OR NIPPV OR mechanical ventilation OR dyspnea 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
      • 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
    • 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
    • GI Bleed:
      • 1L IVF or blood product transfusion prior to decision to admit AND
      • Hct < 21%/Hb < 7 g/dL OR
      • Exertional dyspnea OR MS changes OR
      • INR ≥ 2 OR orthostatic hypotension OR presyncope/syncope
    • CHF
    • HTN
    • Migraine
    • Nephrolithiasis
    • Hypoglycemia
    • Pneumonia
    • PE
    • Pyelonephritis
    • Sickle Cell
    • Stroke
    • Syncope
    • TIA