2011 Performance Measures for Adults With Heart Failure
The target population for the inpatient measures consists of hospitalized patients aged ≥18 years with a principal discharge diagnosis of HF. The principal diagnosis is the condition established after study to be chiefly responsible for the hospitalization. Detailed specifications, including exception criteria, methods of reporting, and additional background, are available on the AMA-PCPI Web site at http://www.ama-assn.org/apps/listserv/x-check/qmeasure.cgi?submit=PCPI. For all inpatient measures, patients who were transferred to another acute care facility, left against medical advice, were discharged to hospice, or died during the index admission are excluded.
The target population for the outpatient measures consists of patients aged ≥18 years with a diagnosis of HF. Detailed specifications, including exception criteria, methods of reporting, and additional background, are available on the AMA-PCPI Web site at http://www.ama-assn.org/apps/listserv/x-check/qmeasure.cgi?submit=PCPI. For purposes of this document, the outpatient care period is defined as the care provided in an outpatient setting within the time period under evaluation (12-month reporting period).
These performance measures are ideally intended for prospective use to enhance the quality improvement process but may also be applied retrospectively. The technical specifications for multiple data sources, including electronic health record data, electronic administrative data (claims), expanded (multiple-source) administrative data, and paper medical record/retrospective data collection flow sheet can be found in Appendix C.
The writing committee added exclusion criteria, recognizing that there are justifiable reasons for not meeting the performance measures. Specific documentation of these measure exceptions, which may be due to patient, medical, or system reasons, should be captured to provide data for future research and facilitate in-depth quality improvement in situations where there are apparent outliers with respect to the number of patients with exceptions.
3. ACCF/AHA/AMA-PCPI 2011 Performance Measures for Adults With Heart Failure
3.1 Inpatient Target Population and Care Period
The target population for the inpatient measures consists of hospitalized patients aged ≥18 years with a principal discharge diagnosis of HF. The principal diagnosis is the condition established after study to be chiefly responsible for the hospitalization. Detailed specifications, including exception criteria, methods of reporting, and additional background, are available on the AMA-PCPI Web site at http://www.ama-assn.org/apps/listserv/x-check/qmeasure.cgi?submit=PCPI. For all inpatient measures, patients who were transferred to another acute care facility, left against medical advice, were discharged to hospice, or died during the index admission are excluded.
3.2 Outpatient Target Population and Care Period
The target population for the outpatient measures consists of patients aged ≥18 years with a diagnosis of HF. Detailed specifications, including exception criteria, methods of reporting, and additional background, are available on the AMA-PCPI Web site at http://www.ama-assn.org/apps/listserv/x-check/qmeasure.cgi?submit=PCPI. For purposes of this document, the outpatient care period is defined as the care provided in an outpatient setting within the time period under evaluation (12-month reporting period).
3.3 Data Collection
These performance measures are ideally intended for prospective use to enhance the quality improvement process but may also be applied retrospectively. The technical specifications for multiple data sources, including electronic health record data, electronic administrative data (claims), expanded (multiple-source) administrative data, and paper medical record/retrospective data collection flow sheet can be found in Appendix C.
3.4 Measure Exceptions and Challenges to Implementation
The writing committee added exclusion criteria, recognizing that there are justifiable reasons for not meeting the performance measures. Specific documentation of these measure exceptions, which may be due to patient, medical, or system reasons, should be captured to provide data for future research and facilitate in-depth quality improvement in situations where there are apparent outliers with respect to the number of patients with exceptions.