Presentation is loading. Please wait.

Presentation is loading. Please wait.

Introduction to Core Measures Lynn Benson Preferred Nurse Staffing.

Similar presentations


Presentation on theme: "Introduction to Core Measures Lynn Benson Preferred Nurse Staffing."— Presentation transcript:

1 Introduction to Core Measures Lynn Benson Preferred Nurse Staffing

2 Core Measures Who is information reported to? Who is information reported to? –JCAHO –CMS –National Patient Safety Foundation

3 ACM Measures Ten Appropriate Care Measures (ACM) are designated by an asterisk*. Ten Appropriate Care Measures (ACM) are designated by an asterisk*. Asks: has a patient received all the care he or she was eligible to receive based on ten- measures (5 AMI, 2 HF, and 3 PN)? Asks: has a patient received all the care he or she was eligible to receive based on ten- measures (5 AMI, 2 HF, and 3 PN)? Measures how often the hospital “ gets it right. ” Measures how often the hospital “ gets it right. ” Focuses on providing “ the right care for every person every time. ” Focuses on providing “ the right care for every person every time. ”

4 Core Measures Public has access to quality information through the Internet Public has access to quality information through the Internet –How does Riley Hospital measure up?? –Check it out at

5 Core Measures Topics focus on health problems most common to the Medicare population Topics focus on health problems most common to the Medicare population Effective interventions have been shown to reduce disability and save lives Effective interventions have been shown to reduce disability and save lives Based on national data, many Medicare patients do not receive important therapies known to decrease morbidity and mortality Based on national data, many Medicare patients do not receive important therapies known to decrease morbidity and mortality

6 Inpatient Core Measure Groups Acute Myocardial Infarction (AMI) Acute Myocardial Infarction (AMI) Congestive Heart Failure (HF) Congestive Heart Failure (HF) Pneumonia (PN) Pneumonia (PN) Surgical Care Improvement Project (SCIP) Surgical Care Improvement Project (SCIP) Childhood Asthma Prevention Childhood Asthma Prevention

7 Core Measures Based on large scale scientific studies with proven efficacy Based on large scale scientific studies with proven efficacy Scientific studies have been incorporated into guidelines developed by professional organizations Scientific studies have been incorporated into guidelines developed by professional organizations Consensus of national experts panel for each measure Consensus of national experts panel for each measure Proven to be measurable and reliable measures of the quality of care Proven to be measurable and reliable measures of the quality of care Focus on clinical processes: all patients, without contraindications, should be considered candidates for therapies Focus on clinical processes: all patients, without contraindications, should be considered candidates for therapies

8 AMI Measures AMI 1 Aspirin w/in 24 hours of arrival* The early use of aspirin in patients with acute myocardial infarction results in a significant reduction in adverse events and subsequent mortality AMI-2 Aspirin at discharge.* Studies have demonstrated that aspirin can Studies have demonstrated that aspirin can reduce this risk by 20%

9 AMI Measures AMI-3ACEI or ARB for LVSD* ACEI therapy reduces mortality and morbidity in patients with left ventricular systolic dysfunction (LVSD/EF less than 40%) after AMI

10 AMI Measures AMI- 4 Smoking Cessation Counseling Smoking cessation reduces mortality and morbidity in all populations. Patients who receive even brief smoking-cessation advice from their care providers are more likely to quit

11 AMI Measures AMI-5Beta Blocker at discharge* Beta blockers prescribed for patients who have suffered an acute myocardial infarction can reduce mortality and morbidity. Studies have demonstrated that the use of beta blockers is associated with about a 20% risk reduction

12 AMI Measures AMI-6Beta Blocker at arrival* RETIRED

13 AMI Measures AMI-7 Median time to fibrinolysis AMI-7a Thrombolytic Agent received within 30 minutes of arrival Time to fibrinolytic therapy is a strong predictor of outcome in patients with an acute myocardial infarction. Consider that nearly 2 lives per 1000 patients are lost per hour of delay

14 AMI Measures AMI-8 Median time to PCI AMI-8a PCI received within 90 minutes of patient arrival The early use of primary angioplasty in patients with acute myocardial infarction who present with ST-segment elevation or LBBB results in a significant reduction in mortality and morbidity The earlier primary coronary intervention is provided, the greater its effect

15 Heart Failure Measures HF –1 Discharge Instructions Written instructions or educational material must address all of the following and must be specific to heart failure: Activity level Diet A written list of discharge medications Follow-up appointment Weight monitoring What to do if heart failure symptoms worsen

16 Heart Failure Measures HF-2LVF assessment* Appropriate selection of medications to reduce morbidity and mortality in heart failure requires the identification of patients with impaired left ventricular systolic function (Ejection fraction less than 40%)

17 Heart Failure Measures HF-3ACEI or ARB for LVSD* ACEI therapy reduces mortality and morbidity in patients with heart failure and left ventricular systolic dysfunction

18 Heart Failure Measures HF-4 Smoking Cessation/counseling Smoking cessation reduces mortality and morbidity in all populations Patients who receive even brief smoking- cessation advice from their care providers are more likely to quit

19 Pneumonia Measures Community Acquired Pneumonia PN-1Retired PN-2Pneumococcal vaccination* Pneumococcal vaccination is indicated for persons 65 years of age and older, because it is up to 75% effective in preventing pneumococcal Pneumococcal vaccination is indicated for persons 65 years of age and older, because it is up to 75% effective in preventing pneumococcal bacteremia and meningitis

20 Pneumonia Measures PN-3a Blood cultures performed w/in 24 hours prior to or after arrival to the ICU PN-3b- Blood cultures preformed in the ED before the initial antibiotic PN-3b- Blood cultures preformed in the ED before the initial antibiotic Published treatment guidelines recommend the collection of blood cultures for all inpatients with severe pneumonia to optimize therapy

21 Pneumonia Measures PN-4 Smoking Cessation/counseling Smoking cessation reduces mortality and morbidity in all populations. Patients who receive even brief smoking-cessation advice from their care providers are more likely to quit Smoking cessation reduces mortality and morbidity in all populations. Patients who receive even brief smoking-cessation advice from their care providers are more likely to quit

22 Pneumonia Measures PN-5a – 8 hours PN-5b Initial antibiotic received within 4 hours of arrival PN-5c - 6 hours … clinical evidence of an association between timely inpatient administration of antibiotics and improved outcome among pneumonia patients

23 Pneumonia Measures PN-6 Initial antibiotic selection for CAP PN 6a ICU patient PN 6b Non- ICU patient

24 Pneumonia Measures PN-7 PN-7 – –Pneumonia patients age ≥ 50 y.o., hospitalized during October, November, December, January, February or March who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated.

25 Surgical Care Improvement Project SCIP- Inf 1 SCIP- Inf 1 Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision The risk of infection increases progressively with greater time intervals between administration and skin incision.

26 SCIP Measures SCIP-Inf 2- Appropriate antibiotic selection SCIP-Inf 3: Prophylactic antibiotic discontinued within 24 hours after surgery SCIP-Inf 6: Appropriate hair removal SCIP-Inf 7: Perioperative normothermia among colorectal surgical patients

27 SCIP Measures SCIP-Card-2 Surgery Patients on Beta Blocker Therapy prior to admission who received a Beta Blocker during the perioperative period.

28 SCIP Pre-Op Document appropriate hair removal-do not use the word shave or razor in the record Document appropriate hair removal-do not use the word shave or razor in the record Document any DVT prevention measures applied at this point (TED’s/SCD’s) Document any DVT prevention measures applied at this point (TED’s/SCD’s) Antibiotic start w/in 60 min of incision (120min for Vancomycin) Antibiotic start w/in 60 min of incision (120min for Vancomycin) Beta Blocker received & documented during peri-operative period if indicated (Medication Reconciliation) Beta Blocker received & documented during peri-operative period if indicated (Medication Reconciliation)

29 SCIP Measures SCIP-VTE-1 Surgery Patients with Recommended Venous Thromboembolism Prophylaxis Ordered SCIP-VTE-2 Surgery Patients Who Received Appropriate VTE Prophylaxis Within 24 Hours Prior to Surgery to 24 Hours After Surgery

30 What can you do to help? Be a part of this successful process Be a part of this successful process Do not underestimate your impact on patient outcomes Do not underestimate your impact on patient outcomes Teach – provide education to your patients as you provide their care Teach – provide education to your patients as you provide their care Documentation – use the proper forms and order sets Documentation – use the proper forms and order sets Talk to your peers and co-workers/make core measures part of your daily vocabulary Talk to your peers and co-workers/make core measures part of your daily vocabulary


Download ppt "Introduction to Core Measures Lynn Benson Preferred Nurse Staffing."

Similar presentations


Ads by Google