SBH Quality Activities
HEDIS (Health Plan Employer Data and Information) is a nationwide
collaborative effort among employers, health plans, and physicians to
monitor and compare health plan performance as specified by the NCQA
(National Committee for Quality Assurance).
Annually, managed care plans submit Health Plan Employer Data and
Information Set (HEDIS) results to NCQA(www.ncqa.org), the National
Committee on Quality Assurance, a not-for-profit organization.
Effectiveness of care is measured in several catagories including:
-Childhood immunization
-Adolescent immunization
-Cervical cancer screening
-Chlamydia screening
-Breast cancer screening
-Comprehensive diabetes care
-Beta blocker treatment after heart attack
-Well child visits
-Prenatal and postpartum care
-Cholesterol management
-Controlling hight blood pressure
-EF measurement and medication doses in CHF
HEDIS/QARR (Quality Assurance Reporting Requirements) Measures:
One NYS Department of Health initiative utilizes HEDIS/QARR guidelines to
recommend that all sexually active women between the ages of 16 and 26 have
at least one test for Chlamydia each year. Most women infected with
Chlamydia do not have reconizable symptoms. Such routine screening is
recommended by:
-US Preventive Services Task Force
-AMA
-ACOG
-AAFP
-AAP
-CDC
The Leapfrog Group is a consortium of Fortune 500 companies and public and
private purchasers that initiated a national campaign in 2000 to recognize
and reward hospitals that adopt initiatives having an effect that improves
patient safety. Currently the Group recommends the following:
-Computer Physician Order Entry
-ICU staffing by intensivist
-Evidence-based hospital referral (www.leapfroggroup.org)
Many hospitals refer to Milliman General Recovery Guidelines when trying to
decide about optimum hospital length of care (www.mnr.com)
Monitoring hospitals for Quality Indicators orchestrated through JCAHO, CMS,
NQF and others. Current key Quality of Care Measures include: 1-Care of
patients with Acute MI; 2-CHF; 3-Pneumonia Components of these three
catatories which are measured include:
Ogygenation assessment (by ABG or pulse ox)
Pneumococcal vaccination and
Flu vaccine (Nov-Feb)
Blood cultures w/in 24 hours and before first antibiotics
First antibiotics under 8 hours of admission (but sooner is better)
And antibiotics should be appropriate (as described by CMS)
Smoking cessation counselling
http://www.ama-assn.org/apps/pf_online/pf_online
http://www.aafp.org/x10600.xml
http://www.aap.org/policy/re9939.html
http://www.acog.com
2004: Typical HEDIS managed care outpatient indicators....
http://www.teacherweb.com/NY/StBarnabas/quality/photo7.stm
SBH Guidelines - only availabel from in hospital intranet
http://bar-mis3/CG/CG_Frames.htm
JCAHO Quality Reports on SBH
http://www.jcaho.org/qualitycheck/directry/QualityReport.aspx?hcoid=5835
JCAHO Quality Report
http://www.jcaho.org/qualitycheck/directry/QualityReport.aspx?hcoid=5835&x=programdetail&program=Hospital
QI and IRB: CatDog
http://chronicle.com/temp/email.php?id=dfi76bv9cd7ht583bgwwr0olksnsrfxw
JCAHO Core Measures of Quality used by Lulu
http://www.jcaho.com/pms/core+measures/aligned_manual.htm
NYS ACP Physician Alliance(MarDon)
http://www.nyacp.org/i4a/pages/Index.cfm?pageID=3443
Other Resources