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Welcome to the latest issue of QI News & Trends, your resource for timely news and journal articles from the world of Quality Improvement. Be sure to subscribe to the Alliance blog for even more QI content and check back regularly to make sure you don’t miss an issue! Want to get QI News & Trends delivered to your inbox? Click here to join the Alliance mailing list or become a member. Is there a story you’d like to see covered in our next issue? Let us know at education@acehp.org

Issue 6: Industry News - April 2017

Table of Contents

  1. NQF's Measure Applications Partnership Identifies Opportunities to Reduce Measure Burden in Federal Healthcare Programs
  2. Vital Directions for Health and Healthcare: Priorities From a National Academy of Medicine Initiative
  3. Associations Between Community Sociodemographics and Performance in HEDIS Quality Measures
  4. Categorization of National Pediatric Quality Measures
  5. ECRI Institute Names Top 10 Patient Safety Concerns for 2017

NQF's Measure Applications Partnership Identifies Opportunities to Reduce Measure Burden in Federal Healthcare Programs
National Quality Forum (03/16/17)

In an effort to ensure quality measurement is enhancing healthcare for patients while reducing burden for providers, the National Quality Forum's (NQF) Measure Applications Partnership (MAP) has made recommendations to improve measure sets used in federal programs. Each year, the U.S. Department of Health and Human Services (HHS) requests and considers MAP's analyses and guidance in the federal rulemaking process for quality and efficiency measures used in various payment and public reporting programs. MAP has recommended that HHS consider the future removal of 51 of 240 measures currently used in seven federal healthcare value-based purchasing, public reporting and other programs. MAP guidance on future removal of measures includes the ESRD Quality Incentive Program (four measures suggested for removal, 18 current measures); PPS-Exempt Cancer Hospital Quality Reporting Program (four measures suggested for removal, 17 current measures); and Ambulatory Surgery Center Quality Reporting Program (two measures suggested for removal, 15 current measures). MAP also provides recommendations for improving measure sets used in nine additional federal programs. For CMS to act on the recommendations, it will likely need to engage in rulemaking as well as consider other programmatic needs not taken into account by the MAP process. "The MAP process fosters a focus on high-value measures that will improve care quality and outcomes for patients," says Chip Kahn, MPH, president and CEO of the Federation of American Hospitals, and co-chair of the MAP Coordinating Committee.

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Vital Directions for Health and Healthcare: Priorities From a National Academy of Medicine Initiative
National Academy of Medicine (03/21/2017) Dzau, Victor J.; McClellan, Mark; Burke, Sheila

The National Academy of Medicine (NAM) has identified priorities that are important to helping the nation achieve better health at lower cost by curbing structural inefficiencies, costs and fragmented care delivery. To this end, NAM has created the Vital Directions initiative that strives for better health and well-being, high-value healthcare, and strong science and technology. Nineteen author groups identified a total of 68 recommended vital directions. For instance, action priorities address the primary contributors to deficiencies in health system performance, such as pay for value and connected care. Essential infrastructure needs include the basic underpinnings for an accountable, efficient and modern health system, such as the use of consistent core metrics to sharpen focus and performance and deriving evidence from care experiences. A standard set of core measures — available at national, state, local and institutional levels — would offer benchmarks for targeting and assessing problems and interventions, as well as provide baseline reference points to improve the reliability of broader measurement, evaluation, accountability and research efforts. Examples of policy initiatives from the Vital Directions discussion papers include providing waivers from Medicare reporting requirements for healthcare organizations working in multi-organization collaboratives to implement and report on core systemwide performance measures, and creating a reimbursement benefit for health systems that facilitates data access and sharing between patients and researchers.

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Associations Between Community Sociodemographics and Performance in HEDIS Quality Measures
American Journal of Medical Quality (03/01/2017) Hu, Jianhui; Schreiber, Michelle; Jordan, Jack

In a recent study, researchers from Henry Ford Health System in Detroit examined whether performance on Healthcare Effectiveness Data and Information Set (HEDIS) measures varied as a function of community sociodemographic characteristics at the primary care clinic level. Between April 2013 and June 2016, they assessed 22 primary care sites of a large multispecialty group practice. The data show significant associations between the sites' performance on certain HEDIS measures and their neighborhood sociodemographic factors. There were more pronounced associations between outcome measures and sociodemographic factors, compared with process measures. In addition, the researchers note, sociodemographic factors played a role in up to 50 percent of the observed variance in some measures, including HbA1c levels.

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Categorization of National Pediatric Quality Measures
Pediatrics (03/15/17) House, Samantha A.; Coon, Eric R.; Schroeder, Alan R.

A recent study sought to identify and classify nationally promoted quality metrics applicable to children, both by type and by content, and to analyze the representation of common pediatric issues among available measures. Researchers identified nationally applicable quality measure collections from organizational databases or clearinghouses and other sources and subsequently screened each measure for pediatric applicability and classified measures as structure, process or outcome using a Donabedian framework. Next, they classified process measures as targeting underuse, overuse or misuse of health services, and by content area, and compared disease-specific metrics to frequency of diagnoses observed among children. A total of 257 unique measures were relevant to pediatric patients. Nearly 60 percent were process measures, and 77 percent of these focused on the underuse of health services. Measures related to depression and asthma were the most common disease-specific measures. Meanwhile, conditions such as respiratory infection and otitis media had fewer associated measures despite their prevalence. The authors conclude, "The content represented among these measures is broad, although there remain important gaps."

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ECRI Institute Names Top 10 Patient Safety Concerns for 2017
ECRI Institute (03/13/2017)

The ECRI Institute has released its "2017 Top 10 Patient Safety Concerns for Healthcare Organizations" report. Topping the list is information management in electronic health records (EHRs). Healthcare providers have large volumes of information to manage, and the introduction of EHRs has made this challenge a key issue. Patient deterioration ranked second on the list because it can have disastrous consequences if undetected. Over the past few decades, improved clinical protocols, training and education for providers and public awareness campaigns have enabled more rapid recognition of, and response to, stroke and ST-elevation myocardial infarction (STEMI). Such STEMI principles could potentially "be applied to other conditions that require fast recognition and management," suggests Patricia N. Neumann, senior patient safety analyst and consultant at ECRI Institute. Implementation and use of clinical decision support (CDS) was third on this year's list, encompassing "tools that we use to ensure that the right information is presented at the right time within the workflow," says Robert C. Giannini, a patient safety analyst and consultant at ECRI. But if implementation or use is suboptimal, opportunities for CDS to aid decision making may be missed. Other concerns on ECRI's list include test result reporting and follow-up, antimicrobial stewardship, patient identification, opioid administration and monitoring in acute care, behavioral health issues in non-behavioral-health settings, management of new oral anticoagulants, and inadequate organization systems or processes to improve safety and quality.

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QI News and Trends Archive

Letter from Ed Dellert,FCEhp President

Issue 1: Industry News - June 2016

Issue 2: Industry News - August 2016

Issue 3: Industry News - October 2016

Issue 4: Industry News - December 2016

Issue 5: Industry News - February 2017


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