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.
Measure Type: Process
Ambulatory Glucose Management
Percentage of diabetic patients, aged 18 years and older, who receive an office-based or ambulatory surgery whose blood glucose level is appropriately managed throughout the perioperative period.
The measure consists of four performance rates:
a. Percentage of patients, aged 18 years and older, with a current diagnosis of diabetes mellitus receiving anesthesia services for office-based or ambulatory surgery whose blood glucose level is tested prior to the start of anesthesia
b. Percentage of patients, aged 18 years and older, with a current diagnosis of diabetes mellitus receiving anesthesia services for office-based or ambulatory surgery who experienced a blood glucose level greater than or equal to 180 mg/dL (10.0 mmol/L) who received insulin prior to anesthesia end time
c. Percentage of patients, aged 18 years and older, with a current diagnosis of diabetes mellitus receiving anesthesia services for office-based or ambulatory surgery who received insulin perioperatively and who received a follow-up blood glucose level check following the administration of insulin and prior to discharge
d. Percentage of patients, aged 18 years and older, with a current diagnosis of diabetes mellitus receiving anesthesia services for office-based or ambulatory surgery who experienced a blood glucose level greater than or equal to 180 mg/dL (10.0 mmol/L) who received education on managing their glucose in the postoperative period prior to discharge
Neuromuscular Blockade and Quantitative Train-of-Four
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.
Continuation of Buprenorphine for Inpatient Surgical Patients or Methadone Therapy during the Perioperative Period for Inpatient and Ambulatory Surgical Patients
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.
Use of Peripheral Nerve Blocks for Pain Management in Hip Fracture Patients
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.
Disease Activity Measurement for Patients with PsA
If a patient has psoriatic arthritis, then disease activity using a standardized measurement tool should be assessed at >=50% of encounters for PsA.
Safe Hydroxychloroquine Dosing
If a patient is using hydroxychloroquine, then the average daily dose should be less than or equal to 5 mg/kg.
Methotrexate to Biologic Adherence to Treatment Pathway for Patients with Rheumatoid Arthritis
Percentage of patients aged 18 years or older with a diagnosis of RA AND receiving a first course therapy using a biologic disease-modifying antirheumatic drug (DMARD) who had a prescription for a conventional synthetic (cs) DMARD at least 10 weeks prior to newly initiated biologic therapy during the measurement year.
Patient Reported Outcome Physical Function Survey for Patients with Rheumatology Conditions
Percentage of patients aged 18 years and older with 2 or more rheumatology encounters with a documented diagnosis of rheumatoid arthritis (RA), psoriatic arthritis (PsA), or systemic lupus erythematosus (SLE) who have an assessment for physical function using ACR-preferred assessment tools or other tools deemed acceptable by the ACR at least once during the measurement year.
Avoiding the Prolonged Use of Moderate/High Dose Glucocorticoids for Patients with Systemic Lupus Erythematosus
Percentage of patients aged 18 years or older with a diagnosis of systemic lupus erythematosus (SLE), who are not prescribed an oral a glucocorticoid at a dose exceeding 5 mg per day prednisone equivalent for greater than 6 months.