Core measures
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Core Measures are a national quality initiative mandated by CMS and TJC to monitor hospital clinical processes and recommended care. Results are published on the CMS website and used for reimbursement and contract negotiations. Measures include AMI, SCIP, VTE, and immunization and focus on topics like fibrinolytic therapy within 30 minutes and controlling postoperative blood glucose. Hospitals must meet inclusion/exclusion criteria and pass random validation to avoid penalties.
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Core measures
Core measures are evidence-based standards established by CMS to improve patient outcomes. Hospitals must report on core measures to receive reimbursement, and this data is publicly reported. At WCMC, teams monitor measures for conditions like AMI, HF, PN, surgery, VTE, and stroke. The red chart identifies patients for core measures, which staff must ensure are addressed according to guidelines. Measures include things like timely treatment, screening, counseling, and discharge instructions. Accurate documentation and coordination between staff is important for compliance.
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Core Measures1
The core measures were developed to compare quality of care across hospitals using standardized clinical indicators. They aim to ensure a minimum standard of care for common diagnoses. The Joint Commission initially developed four core measurement areas in 1999-2001 related to conditions like heart attacks, heart failure, and pneumonia. Hospitals became required to report on core measures to CMS in 2002. Core measure sets have expanded to include additional clinical areas and quality measures. Meaningful use requires use of electronic health records to report core measures in order to receive incentive payments after 2015.
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Core measures
- 1. Core Measures for 2015
- 2. Core Measures are a national quality initiative • Mandated by the Center for Medicare and Medicaid services (CMS) and the Joint Commission (TJC) to monitor specific hospital clinical processes and how well hospitals provide recommended care • Evidence Based Practice • All major payers moving toward using Core Measure results to benchmark & for contract negotiations • Basis for Medicare Pay for Performance/ Value Based Purchasing • As of 2013 also the basis for physician reimbursement
- 3. Core Measures is a national quality initiative • Rigorous “inclusion” and “exclusion” criteria & guidelines for acceptable documentation • Results undergo random validation studies (penalties for failing validation) • Data published on the CMS website http://www.hospitalcompare.hhs.gov
- 4. Hospital Inpatient • Acute Myocardial Infarction (AMI) • Heart Failure (HF) Retired • Pneumonia (PN) Retired • Surgical Care Improvement Project (SCIP) • Venous Thromboembolism (VTE) • Stroke (STK) • Emergency Department (ED)Throughput Measure -Admitted patients • Global Immunization Measures (IM)
- 5. AMI • AMI-7a Fibrinolytic Therapy received within 30 minutes of hospital arrival
- 6. SCIP • INF-4 Cardiac Surgery patients with controlled postoperative blood glucose (180 <or= mg/dL) in the timeframe of 18-24 hours after anesthesia end time
- 7. VTE • VTE-1 Pts who receive VTE prophylaxis or who have documentation supporting why no VTE prophylaxis was given day of or day after admission or surgical procedure. • VTE-2 Pts who receive VTE prophylaxis or who have documentation supporting why no VTE prophylaxis was given day of or day after admission to ICU or surgical procedure • VTE-3 Pts diagnosed with confirmed VTE who receive overlap of parenteral (intravenous [IV] or subcutaneous [SQ] anticoagulation) and Coumadin therapy. A minimum of 5 days of parenteral anticoagulation is recommended as “overlap therapy” and should continue until the INR>/=2, even if it takes longer than 5 days. For pts with <5 days of tx or <2 INR, documentation must show reason for Dcing parenteral tx