Module 4 Part 3 Operationalizing the Measures

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Presentation transcript:

Module 4 Part 3 Operationalizing the Measures Adapted from: The Institute for Healthcare Improvement (IHI), the Agency for Healthcare Research and Quality (AHRQ), and the Health Resources and Services Administration (HRSA) Quality Toolkits

Objectives Discuss the operational definitions of a family of measures Describe data sources for access to those measures

Creating Operational Definitions Why are operational definitions important?

Operational Definitions Operational definitions specify: What data will be collected When (the frequency of measurement) How (using EHR, CRF, surveys, etc) Agreement must be reached by team Agreement must include: Who will collect the data Criteria for judgment of data quality Missingness and proportion of eligible patients done

Choose & Operationalize Performance Measures Include staff in the measure selection process Choose performance measures with the following characteristics: Align with your organization’s goals Demonstrate a relationship to positive health outcomes Under the control of the healthcare system Reliable, valid, and standardized

Operational Definition Example: Discharge Care Medication Measure Criteria: Complete for all STEMI patients with stent at discharge. Medication Reconciliation at discharge Process Measure: Address indication, action, dose, how to take 1= Yes; 0=No; U=Unknown; NA=NA (no points) New medications were addressed? Changes to home medications were addressed? Deletions to home medications were addressed? Continuation of home medications addressed? Total score (total answered yes, no, or unknown (one for yes, or zero for no or unknown) *Submit summary data each month on the 15th day, 6 weeks after the 30th day of the month. Example: January patients are due March 15 Criteria for use specified? What, When, How to collect data for the measure? Who will complete the data form or audit—agreed upon and clear?

Operational Definition Example: Discharge Care Medication Measure Data dictionary: Include additional details on the measure. Medication Reconciliation at discharge Process Measure: Address indication, action, dose, how to take What population: Inclusion/exclusion; numerator/denominator What type of measure, improvement target specified? Data element definition: ICD-9 vs ICD-10 Sampling specification? Analysis suggestions? Risk adjustment; accuracy, data cleaning specified? Reporting recommendations: Aggregate rate generated from count data and reported as a proportion

Example Comments Electronic health records (EHRs) can be helpful in constructing and tracking quality measures EHRs aid in quality improvement by improving clinical documentation and by making standardized patient data readily available for collection EHRs are a source of detailed, current patient information for use in constructing performance measures

Summary Select an AIM Select measures for each AIM Include a FAMILY of operational measures Process Outcome Balancing / Structure Operationalize definitions for each measure