Chapter 4 - Quality Measures

Question 1

What are the goals of Value Based Purchasing?

Answer 1

• Eliminating or reducing the occurrence of adverse events (healthcare errors resulting in patient harm)
• Adopting evidence-based care standards and protocols that result in the best outcomes for the most patients
• Re-engineering hospital processes that improve patients’ experience of care
• Increasing the transparency of care for consumers
• Recognizing hospitals that are involved in the provision of high-quality care at lower cost to Medicare

Question 2

What are the 4 quality metrics established by the Joint Commission?

Answer 2

▪ Research: demonstration of outcome improvement through evidenced based care
▪ Proximity: the measure must have a direct impact on patient outcome
▪ Accuracy: An assessment of weather the care was actually provided and delivered accurately
▪ Adverse effects: the implemented measure should have no adverse effect to the patient

Question 3

What are the HEIDIS 6 domains of care?

Answer 3

• Effectiveness of care
• Access/availability of care
• Experience of care
• Utilization and risk adjusted utilization
• Health plan descriptive information
▪Measures collected using electronic data systems

Question 4

What are the advantages of eCQM?

Answer 4

• Allow the focus to be on patient care rather than paperwork
• Save time by promoting use of the electronic health record instead of abstracting charts manually
• Facilitate the use of real-time data to assist in quality improvement and clinical decision making
• Assess the quality of treatment by providers and healthcare organizations
• Assist in reducing costs by identifying measures that can prevent readmission and medication errors

Question 5

AHRQ has developed three standard sets of quality indicators

Answer 5

• Patient Safety Indicators (PSI)
• Pediatric Quality Indicators (PDI) and Neonatal Quality Indicators (NQI)
• Inpatient Quality Indicators (IQI)

Question 6

CMS Star Rating Program Includes

Answer 6

• Mortality 22% 
• Safety of Care 22%
         **must include one of these two
• Readmission 22%
• Patient Experience 22%
•Timeliness of Care 12%

**Must have three to be counted

Question 7

Hospital Readmission Reduction Program (HRRP) penalizes based on:

Answer 7

• Acute myocardial infarction (AMI)
• Chronic obstructive pulmonary disease (COPD)
• Heart failure (HF)
• Pneumonia
• Coronary artery bypass graft (CABG) surgery
• Elective primary total hip arthroplasty and/or total knee arthroplasty (THA/TKA)

Question 8

The safety domain of VBP includes:

Answer 8

CAUTI
CLABSI
CDIFF
MRSA
SSI (surgical site infection - colon and abdominal hysterectomy)