Measure Type: High Priority

The percentage of patients, aged 1 and above, who undergo a surgical, therapeutic, or diagnostic procedure that involves using a non-depolarizing neuromuscular blockade medication who have a documented quantitative train-of-four ratio of greater than or equal to 0.9 before tracheal extubation in the operating room, post-anesthesia care unit, non-operating room anesthetizing location, or earliest extubation.

Percentage of patients, age 13 and older, undergoing an inpatient surgical procedure who have an outpatient prescription for buprenorphine/naloxone or suboxone in their admissions documentation, who are continued on buprenorphine for the duration of their inpatient stay or undergoing an inpatient or ambulatory surgical procedure who are taking methadone as outpatients or who have a prescription for methadone in their admittance documentation, and where methadone is either continued or changed to an equivalent IV dose to maintain the therapeutic level regimen during the perioperative period. For patients receiving care in an ambulatory surgical setting, methadone medication was provided as scheduled before surgery.

This measure will consist of two performance rates:
Measure A: Percentage of patients, age 13 and older, undergoing an inpatient surgical procedure who have an outpatient prescription for buprenorphine/naloxone or suboxone in their admissions documentation are continued on buprenorphine for the duration of their inpatient stay.

Measure B: Percentage of patients, 13 years and older, undergoing an inpatient or ambulatory surgical procedure who are taking methadone as outpatients or who have a prescription for methadone in their admittance documentation and where methadone is either continued or changed to an equivalent IV dose to maintain the therapeutic level regimen during the perioperative period. For patients receiving care in an ambulatory surgical setting, methadone medication was provided as scheduled before surgery.

NOTE: The overall measure score will be calculated as an average of the performance rates of A and B. In order to be scored on this measure, clinicians must have at least one eligible case reported for each sub-metric: Measure A and Measure B.

All patients, aged 65 and older, who are diagnosed with a hip fracture and receive peripheral nerve blocks for pain management in the emergency room or inpatient setting.

Percentage of patients who undergo an open cardiac procedure over 240 minutes duration and who receive initial cephalosporin within 60 minutes before surgical incision and receive either a bolus infusion or an intravenous cephalosporin antibiotic re-dose at four-hour intervals.

Percentage of patients with a documented urinalysis or urine culture within 14 days prior to surgical stone procedures

This measure assesses the appropriate use of echocardiograms in patients with CHF. It evaluates the percentage of patients who receive echocardiograms without a clinical change or cardiac procedure within 24 months of the date of service (DOS), indicating potential overuse of this diagnostic test.

This measure assesses the appropriate use of noninvasive ischemic imaging in patients with chronic coronary disease in accordance with the 2023 ACC/AHA guidelines on the management of chronic coronary disease. It evaluates the percentage of patients who received imaging without a clinical change or pre-operative indication, signaling potential overuse of cardiac imaging.