Provider Quality Measures


There are many quality measures that exist to bolster the quality of service given in a healthcare environment. This program is here to make use of any and all measures that would serve that purpose, to improve the quality of healthcare.

The measures we have are all rate based measures, a numerator over a denominator population. We have 10 outpatient measures and 3 inpatient measures. They are as follows:

Outpatient

  1. Discharged on Antithrombotic Therapy for Stroke. Based on PQRS measure 32. This measure is a lot like the old core measure stroke 2, it measures whether an eligible patient received antithrombotic therapy as they were discharged from the hospital, unless there is documented contraindications.

  2. Perioperative Temperature Management. Based on PQRS measure 193. This measure can be compared to the old core measure SCIP 10, it measures if a patient going into a long surgery had warming techniques employed and if the patient’s temperature was monitored in the perioperative period.

  3. Hemoglobin A1c Poor Control. Based on PQRS measure 1. This is simply an entry field for the patient’s hemoglobin A1c level if they are diagnosed with diabetes. This measure creates at least two opportunities for improvement: the frequency of testing, and the medication management of patients who are not well-controlled.
  4. Screening or Therapy for Osteoporosis in Women 65 and Older. Based on PQRS measure 39. The measure dictates that if an eligible female patient has had a screening for osteoporosis, and if a diagnosis for osteoporosis is made during a visit, they should also be getting treatment for it, unless there’s clinician documentation of a reason for excluding the patient from therapy. 

  5. Pharmacologic Therapy for People 50 and Older. Based on PQRS measure 41. This is another measure based on taking care of patients with osteoporosis. It demands pharmacologic therapy to deal with osteoporosis, unless there is a documented contraindication.
  6. Blood Pressure Management for Adult Kidney Disease. Based on PQRS measure 122. This measure is for patients with a diagnosis of chronic kidney disease (CKD) that are also not receiving renal replacement therapy (RRT). The measure classifies RRT as also including hemodialysis, peritoneal dialysis, and kidney transplant. The measure needs blood pressure to be measured, and if the patient has hypertension for there to be a plan of care for them.

  7. Lipid Profile Lab Testing for Adult Kidney Disease. Based on PQRS measure 121. This measure tracks the blood pressure of people with CKD not on RRT, just like the last one. The measure looks for a fasting lipid profile within a 12 month period. 
  8. Pneumonia Vaccination Status for Older Adults. Based on PQRS measure 111. This measure just keeps track of older patients, making sure they get their pneumonia vaccination when they are eligible.

  9. Avoidance of Antibiotic Treatment in Adult Acute Bronchitis. Based on PQRS measure 116. This measure is just as it sounds, avoiding using an antibiotic for an acute bronchitis diagnosis. Though there’s plenty of reasons for prescribing an antibiotic, they are marked as medical exclusions. Patients previously given antibiotics in the past 30 days are excluded.

  10. Eye Exam Due to Diabetes. Based on PQRS measure 117. This measure makes sure those with diabetes are screened for glaucoma and blindness.

Inpatient

  1. Venous Thromboembolism Prophylaxis. Based on inpatient core measure VTE-1. This measure assesses the number of patients who received VTE prophylaxis or have documentation of why no VTE prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day of or the day after hospital admission.

  2. Intensive Care Unit VTE Prophylaxis. Based on inpatient core measure VTE-2. Just like VTE-1 this measure makes sure those that needed VTE prophylaxis received it, but this measure makes note of ICU patients and treats them slightly differently.

  3. Anticoagulation Overlap Therapy. Based on inpatient core measure VTE-3. This measure assesses the number of patients diagnosed with confirmed VTE who received an overlap of parenteral anticoagulation and warfarin therapy or lack thereof.
RWHC provides this and many other services to stimulate quality improvement at hospitals and other health care facilities. Please look at other programs that are offered here at RWHC as well. Then call us to discuss current pricing and packages that meet your facility’s needs.

For more information contact Lauri Brown at lbrown@RWHC.com , or 1-800-225-2531.

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