Monday, April 11, 2011

Healthcare Quality Indicators - Primer

Clinical Quality Indicators have become beacons for measuring care delivery standards. In June'08 CMS and HQA (Hospital Quality Alliance) started to public report 30 day mortality measures for AMI, HF and PN. Since then the reporting has included 30 readmission for these conditions and in-hospital adverse events. Based on claimms and administrative data, CMS calculates the following categories for public reporting
30 day risk standardized mortality measures
30 day risk standardized readmission rates
AHRQ Patient Safety Indicators
AHRQ Inpatient Quality Indicators
Hospital Acquired Conditions Measures (Includes Surgery Infection Prevention)
In addition, AHRQ has Pediatrics Quality Indicators and Patient Safety Indicators

While hospitals engage to collect and cogently present the KPI information - 3 questions need to be asked:
How did the organization identify who its key stakeholders for outcomes information were? How were the stakeholders' outcomes information needs determined? What were the stakeholders' information needs and preferred reporting formats?

Eligible hospitals and Critical Access Hospitals must report all 15 Clinical Quality Measures for Stage 1

In all 44 clinical quality measures were adopted for EPs. They appear in table 6 of the final rule (beginning p. 44398). The table includes the applicable NQF measure number and the PQRI implementation number, title, description, owner/steward. Where applicable, link are provided to existing electronic specifications. All of the measures have broad applicability to the range of Medicare-designated specialties and the services provided by EPs.

EPs must report clinical quality measures results (numerators, denominators, and exclusions) to CMS. Clinical Quality Measure Priorities PQRI measures 1, 2, 3, 5, and 7 represent CMS and Health and Human Services healthcare quality priorities. They address chronic conditions of diabetes, coronary artery disease, and heart disease. PQRI measures 66, 110 –115, and 128 support screening and prevention, also a high priority for CMS and HHS. Check out Table 6 of the Final Rule on MU

More to come....

Health Management in India

http://www.ihmr.org/ - Institute of Health Management
http://www.iphindia.org/joomla/index.php - Institute of Public Health
http://www.who.or.jp/sites/bangalore.html - WHO, Bangalore
http://cghr.org/aboutcghr.html - Center for Global Health Research
http://www.hispindia.org/ - HISP India
- PHFI Newsletter
http://www.epos.in - EPOS India