Interqual vs. Millman

[Erwende]

I tried "googling" this but nothing comes up. We use Interqual at my facility. What is the difference between the two?

[nurseprnRN, BSN, RN]

Distinction without much of a difference. Both use pretty much the same criteria. Just different format.

[d'cm]

I have to disagree with greentea, the two have completely different approaches. Interqual determines acuity based on severity of illness (SI) and intensity of service ( IS) for the generalized body systems. SI criteria is well defined but rigid and have to add up to a certain number for a person to be "sick enough' to be admitted or observed. After they are admitted they have to a minimum amount of stuff being done to them to meet IS. This makes it all pretty easy for the nurse to do but the big problem is that doctors don't ( and shouldn't ) think that way. Hey doc, can you add another IV med so the patient meets criteria? I don't think so.

Milliman on the other hand is based on specific diagnosis, outlining what symptoms and diagostic tests should be showing for the patient to be considered acutely ill. Then lays out the expected path to recovery. Each progressive step is considered a day but that "day' could take a week. It is also very helpful in setting up discharge plans. I have worked with both for many years, obviously I prefer Milliman.

[SummerGarden, BSN, MSN, RN]

I have to disagree with greentea the two have completely different approaches. Interqual determines acuity based on severity of illness (SI) and intensity of service ( IS) for the generalized body systems. SI criteria is well defined but rigid and have to add up to a certain number for a person to be "sick enough' to be admitted or observed. After they are admitted they have to a minimum amount of stuff being done to them to meet IS. This makes it all pretty easy for the nurse to do but the big problem is that doctors don't ( and shouldn't ) think that way. Hey doc, can you add another IV med so the patient meets criteria? I don't think so. [/quote']

No, not any more. Interqual does not use IS and SI criteria anymore as of the 2012 edition. Those were replaced with condition specific criteria as well as diagnostics, treatment, and expected therapies based upon evidenced based medical practice. Also, Interqual has days in each condition category, but those days can be exhausted and go to extended category, where complications and other factors may be the reason the patient is still in the hospital. Also, Sx is now more comprehensive and so is Trauma compared with past editions.

[d'cm]

thanks for the info, that is a huge change for Interqual.