performance and reporting this performance on their Web site, Hospital
Compare. It is unknown whether these process performance measures are
related to hospital-level outcomes.
#12
The Surgical Care Improvement Project (SCIP) is a national partnership
of organizations committed to improving the safety of surgical care
through the reduction of post-operative complications. Partners in the
SCIP believe that a meaningful reduction in complications requires that
surgeons, anesthesiologists, perioperative nurses, pharmacists,
infection control professionals and hospital executives work together to
intensify their commitment to making surgical care improvement a
priority.
In addition to continuing to reduce surgical site infections (SSIs), the
SCIP Partnership is broadening the scope of the new national project by
targeting additional adverse events to include cardiac, respiratory and
venous thromboembolic complications.
Quality Measures
Acute Myocardial Infarction (AMI):
Aspirin at arrival
Aspirin prescribed at discharge
Beta Blocker at arrival
Beta Blocker prescribed at discharge
ACE inhibitor or ARB for left ventricular systolic dysfunction
Optional Measures:
Smoking cessation advice/counseling
Thrombolytic agent received within 30 minutes of hospital arrival
PCI received within 120 minutes of hospital arrival
Heart Failure (HF):
Left ventricular function assessment
ACE inhibitor/ARB for left ventricular systolic dysfunction
Optional Measures:
Discharge instructions
Smoking cessation advise/counseling
Pneumonia (PNE):
Initial antibiotic received within four hours of hospital arrival
Oxygenation assessment within 24 hours of hospital arrival
Pnuemococcal vaccination
Optional Measures:
Blood culture performed prior to the initial antibiotic received in the
hospital
Initial antibiotic selection for community acquired pneumonia in
immunocompetent patients
Adult smoking cessation advice/counseling
Influenza vaccination
#13
IHI 5 Million Lives Campaign
The Institute for Healthcare Improvement (IHI) has launched the 5
Million Lives Campaign, an initiative to protect patients from five
million incidents of medical harm over the next two years (December 2006
- December 2008)
Proven Interventions
The 5 Million Lives Campaign challenges American hospitals to adopt 12
changes in care that save lives and reduce patient injuries:
The six interventions from the 100,000 Lives Campaign
* Deploy Rapid Response Teams...at the first sign of patient
decline
* Deliver Reliable, Evidence-Based Care for Acute Myocardial
Infarction...to prevent deaths from heart attack
* Prevent Adverse Drug Events (ADEs)...by implementing medication
reconciliation
* Prevent Central Line Infections...by implementing a series of
interdependent, scientifically grounded steps
* Prevent Surgical Site Infections...by reliably delivering the
correct perioperative antibiotics at the proper time
* Prevent Ventilator-Associated Pneumonia...by implementing a
series of interdependent, scientifically grounded steps
New interventions targeted at harm
* Prevent Harm from High-Alert Medications... starting with a
focus on anticoagulants, sedatives, narcotics, and insulin
* Reduce Surgical Complications... by reliably implementing all of
the changes in care recommended by SCIP, the Surgical Care Improvement
Project ([Ссылки доступны только зарегистрированным пользователям ])
* Prevent Pressure Ulcers... by reliably using science-based
guidelines for their prevention
* Reduce Methicillin-Resistant Staphylococcus aureus (MRSA)
infection...by reliably implementing scientifically proven infection
control practices
* Deliver Reliable, Evidence-Based Care for Congestive Heart
Failure... to avoid readmissions
* Get Boards on Board ... by defining and spreading the best-known
leveraged processes for hospital Boards of Directors, so that they can
become far more effective in accelerating organizational progress toward
safe care
#14
The Appropriate Care Measure Identified Participant Group
The Appropriate Care Measure (ACM) Identified Participant Group (IPG) is
a hospital initiative designed to bring transformational change to the
health care arena and raise the bar for performance to provide the right
care for every patient, every time.
Project Goals
Provide information and assistance to assess and improve
hospital systems in managing three clinical conditions -- Acute
Myocardial Infarction, Heart Failure and Pneumonia -- and ten publicly
reportable quality-of-care measures
Expand public reporting of performance measures to include all
Hospital Quality Alliance (HQA) proposed indicators
ACM Scoring Methodology
The ACM is a composite measure based upon five AMI measures, two Heart
Failure measures, and three Pneumonia measures. All patients eligible
for at least one of the ten measures are counted in the denominator. To
be counted in the numerator, the patient must receive all of the care
specified by the measures that the patient is eligible for. There is no
weighting in this calculation.
For example:
Mr. S is admitted with an AMI, and by chart abstraction, is eligible for
aspirin and Beta Blockers but is not eligible for ACEI or ARB upon
discharge. Mr. S is eligible for
Aspirin upon arrival
Aspirin at discharge
Beta Blocker at arrival
Beta Blocker prescribed at discharge
Chart abstraction results:
Received aspirin upon arrival? Yes
Received aspirin at discharge? Yes
Received Beta Blocker at arrival? Yes
Received Beta Blocker at discharge? No
Analysis:
Mr. S fails the ACM because a single element of care for which he is
eligible was not provided, namely the Beta Blocker at discharge.
The move to a patient-centric measure rather than a process-centric
measure is in keeping with the CMS mantra of "The Right Care for Every
Person Every Time." Given this change, it is important to realize that
if you are doing well at every process but one, your score CANNOT exceed
your weakest score.
#15
Home Health Quality Initiative Quality Measures for Public Reporting
OASIS Outcome Measure Consumer Language
Improvement in upper body dressing Patients who get better at
getting dressed
Improvement in bathing Patients who get better at bathing
Stabilization in bathing Patients who stay the same (don't get
worse) at bathing
Improvement in toileting Patients who get better getting to and
from the toilet
Improvement in ambulation/locomotion Patients who get better at
walking or moving around
Improvement in transferring Patients who get better at getting in
and out of bed
Improvement in management of oral medications Patients who get better
at taking their medicines correctly (by mouth)
Improvement in confusion frequency Patients who are confused less
often
Improvement in pain interfering with activity Patients who have less
pain when moving around
Acute care hospitalization Patients who had to be admitted to the
hospital
Any emergent care provided Patients who need urgent, unplanned
medical care
#16
The Leapfrog Group
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]
1. What measures are included in Leapfrog Hospital Insights?
Leapfrog Hospital Insights measures quality, efficiency and overall
performance in five clinical areas. The quality measures are a
combination of Joint Commission Accreditation of Healthcare
Organizations (JCAHO) core measures - processes of care that should be
standard for every applicable admission - and the Leapfrog Hospital
Quality and Safety Survey, which focuses on patient safety practices
known to reduce preventable medical mistakes. The Leapfrog Hospital
Insights efficiency measure is the first nationally collectable and
comparable measure of hospital resource efficiency. The five areas of
inpatient care measured by Leapfrog Hospital Insights are the following:
* Acute myocardial infarction (AMI), commonly known as heart
attack;
* Coronary artery bypass graft (CABG), commonly known as bypass
surgery;
* Percutaneous coronary intervention (PCI), commonly known as
angioplasty;
* Community-acquired pneumonia (CAP); and
* Deliveries/newborn care.
#17
Quality Tools
[Ссылки доступны только зарегистрированным пользователям ]
okup_id=528&mode=4
#18
Quality Indicator Project (QI Project)
[Ссылки доступны только зарегистрированным пользователям ]
#19
National Quality Measures Clearinghouse:
[Ссылки доступны только зарегистрированным пользователям ]
#20
National Quality Forum (NQF) [Ссылки доступны только зарегистрированным пользователям ]
Note: Norton Healthcare is a member of NQF.
* hospital care
* cardiac surgery - also see - The Society for Thoracic Surgeons
(STS)
* nursing-sensitive care
* ambulatory (physician office) care
* safe practices
#21
Norton HealthCare Quality Report
[Ссылки доступны только зарегистрированным пользователям ]
Quality Indicators Included:
Patient satisfaction
Nursing care
Antibiotic susceptibility
Patient safety
Infection control
Other indicators
Surgery
Childbirth
Pneumonia
Childbirth - other
Heart failure
Children
Heart attack
Safe practices
Cardiovascular procedures
Cancer survival rates
Physician office care
Data validity
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