Percentage of emergency department visits for admitted patients aged 18 years and older where an indwelling Foley catheter is ordered and the patient had at least one indication for an indwelling Foley catheter
Category: Quality Measures
ED Median Time from ED arrival to ED departure for all Adult Patients
Time (in minutes) from ED arrival to ED departure for all Adult Patients
ED Median Time from ED arrival to ED departure for all Pediatric ED Patients
Time (in minutes) from ED arrival to ED departure for all Pediatric Patients
Appropriate Emergency Department Utilization of Lumbar Spine Imaging for Acute Atraumatic Low Back Pain
Percentage of emergency department visits during which patients aged 18 years and older had a CT or MRI of the Lumbar Spine ordered by an emergency care provider, regardless of discharge disposition, presenting with acute, atraumatic low back pain.
Appropriate Use of Imaging for Recurrent Renal Colic
Percentage of emergency department visits for patients aged 18-50 years presenting with flank pain with a history of kidney stones during which no imaging is ordered, OR appropriate imaging (plain film radiography or ultrasound) is ordered.
Otolaryngologic Surgical Procedures: Avoidance of Unnecessary Antibiotic Use
Percentage of patients aged 1 year and older who underwent an otolaryngologic surgical procedure and did not receive perioperative or postoperative antibiotics when there were no clinical indications, based on evidence-based guidelines.
Measuring the Value-Functions of Primary Care: Comprehensiveness of Care
This measure evaluates the extent primary care physicians (PCPs) perform care-based and procedural-based services core to primary care (licensure ensures competence of these services). For each PCP, the resulting value reflects an average of the weighted proportion of services within each category performed during the measurement period.
Scores are based on weighted averages of 19 care-based and 20 procedural-based core primary care services resulting in scores between 0 and 100.
Inclusion criteria: Primary care physicians who have provided care to 30 or more patients regardless of age within the measurement period (the performance year and the 12 months prior to the performance year).See Figure 1: Physician and Care Site Identifier in the Measure Specification Figures and Tables document under the Additional Supporting Documentation section for the variables used to determine if physicians meet the inclusion criteria (Step 1 and 2 of the Measure Calculation Algorithm (also found in the Measure Specification Figures and Tables document).
Throughout this application, since the fields do not accept scientific formulas, tables or figures, we have attached those items in the Additional Supporting Documentation section.
Measuring the Value-Functions of Primary Care: Physician Level Continuity of Care Measure
The measure calculates the percentage of a physician’s patients who have a continuity index of at least 0.7 (excluding patients with < 2 primary care visits during the measurement period). This is a physician-level measure for use in evaluating physician behavior; it leverages a previously validated continuity index that quantifies the extent to which patients experience continuity of provider in their primary care visits.
This measure evaluates the extent to which primary care physicians (PCPs) are supporting the continuity of care of their patients. High care continuity is shown to improve patient outcomes and physician well-being, is associated with decreased health care costs (total, ED, inpatient, primary care, and costs for specific conditions or treatments) and health care utilization (ED visits and hospitalizations). As a byproduct of building a trusting relationship over time, issues of equity and social risk can be addressed. Physicians who perform better are likely to have specific structures and processes in place that are conducive to allowing patients to achieve higher care continuity.
Compared to lower scores (e.g., 0.6 or lower), continuity index scores of 0.7 or higher have been associated with significantly lower Medicare expenditures and significantly lower odds of hospitalization.1
References:
1. Higher Primary Care Physician Continuity is Associated with Lower Costs and Hospitalizations. Bazemore et al. Annals of Family Medicine. 2018. 16, 492-497.
Low Flow Inhalational General Anesthesia
Percentage of patients aged 18 years or older, who undergo an elective procedure lasting 30 minutes or longer requiring inhalational general anesthesia who during the maintenance phase of the anesthetic have a total fresh gas flow less than or equal to 1 L/min (less than or equal to 2 L/min for Sevoflurane).
Aspiration prevention in patients with gastric distension
Percentage of patients 18 years and older with a current diagnosis of gastrointestinal obstruction, ileus, incarcerated hernia, or patients taking GLP-1 receptor agonists, or patients with gastroparesis, who undergo a surgical procedure under anesthesia and are treated preoperatively with a mitigation strategy that reduces the risk of aspiration during the surgical procedure.
Instructions
This measure is to be reported each time an adult patient with one or more of the following conditions undergoes a surgical procedure under anesthesia:
a) has gastrointestinal obstruction, ileus, or an incarcerated hernia
b) is taking a GLP-1 receptor agonists
c) has gastroparesis