Topic

Quality of Care Measures

Acute Myocardial Infarction

1. Early administration of aspirin.
2. Aspirin at discharge.
3. Early administration of beta blocker.
4. Beta blocker at discharge.
5. ACE inhibitor at discharge for patients with systolic dysfunction.
6. Time to initiation of reperfusion therapy.
7. Smoking cessation counseling.

Heart Failure

1. Evaluation of left ventricular function before or during hospitalization.
2. ACE inhibitor at discharge for patients with systolic dysfunction.
3. Discharge instructions.
4. Smoking cessation counseling.

Pneumonia

1. Blood culture before antibiotics.
2. Time to initial antibiotic administration (NOTE: target time is currently 8 hours, but is likely to change to 4 hours reflecting expected evidence-based revision of specialty society guidelines).
3. Administration of antibiotics consistent with current guidelines.
4. Pneumococcal (PPV) immunization (inpatient).
5. Influenza immunization (inpatient).
6. Oxygenation assessment within 24 hours of hospital arrival.
7. Smoking cessation counseling.

Prevent surgical infections

1. Correct prophylactic antibiotic.
2. Correct timing of antibiotic administration.
3. Correct duration of antibiotic administration.

Topic

Quality of Care Measures

Chronic Care for Diabetes

1. Biennial retinal exam by an eye professional.
2. Annual HbA1c testing.
3. Biennial testing of lipid profile.

Preventive Services

Cancer Screening

1. Biennial screening mammography.

Adult immunizations

1. Influenza immunization (full state Medicare population).
2. Pneumococcal (PPV) immunization (full state Medicare population).

Topic

Quality of Care Measures

Chronic Care

1. Percentage of residents with pain.
2. Percentage of residents with infections.
3. Percentage of residents with pressure sores.
4. Percentage of residents with pressure sores (with additional level of risk adjustment).
5. Percentage of residents with loss of ability in some basic daily tasks.
6. Percentage of residents in physical restraints.
7. Percentage of short stay residents with delirium (with additional level of risk adjustment).

Post-Acute Care

1. Percentage of short stay residents with pain.
2. Percentage of short stay residents who walk as well or better.
3. Percentage of short stay residents with delirium.

Topic

Quality of Care Measures

Health Status Improvement

(QIOs are training home health agencies to improve care measured by these and other indicators.)

1. Percent of patients who get better at getting dressed (upper body).
2. Percent of patients who get better at bathing themselves.
3. Percent of patients who are confused less often.
4. Percent of patients who get better at correctly taking their medicines (by mouth).
5. Percent of patients who get better at walking or moving around using less equipment (such as a cane, walker, or wheelchair).
6. Percent of patients who get better getting to and from the toilet.
7. Percent of patients who get better at getting in and out of bed.
8. Percent of patients who have less pain when moving around.
9. Percent of patients who stay the same (don’t get worse) at bathing themselves.
10. Percent of patients who need urgent medical care (for any reason).
11. Percent of patients who had to be admitted to the hospital.