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For the Emergency Care Access & Timeliness eCQM, a volume-adjusted z-score shows how an ED's performance compares to the average for similar-volume EDs, addressing differences in patient population in HOPDs and ensuring fair like to like comparisons between EDs of similar size

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If you add the same 2ml of bacteriostatic water, you get a concentration of 5mg/ml instead of 2.5mg/ml