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ORGANIZATIONS BEHIND
    MEASUREMENT SETS

  NQF
  AHRQ
  CMS
  JCAHO
  NCQA
  AMA - PCPI
  AQA
  AHA
  SCIP
  IHI
  ACC
  STS
  Premier-CMS
  COAP


MEASUREMENT SETS
  AQA – AQA Measures
  AQA – Cardiac Surgery
  AQA – Cardiology
  CMS – HQA
  CMS – PVRP
  NQF – Cardiac Surgery
  Premier-CMS – HQI
  SCIP


PERFORMANCE MEASURES
    CROSSWALK BY TOPIC

  Patient Safety
  CABG / Cardiac Surgery
  PCI (angioplasty)
  ACS / AMI


PERFORMANCE MEASURE
    CODING

  HIPAA Standard Codes


 

Acute Coronary Syndrome (ACS) /
Acute Myocardial Infarction (AMI)

ACS / AMI - Specific Measures
Clinical Measure/Condition
NQF
AHRQ
Anti-platelet Therapy During Hospitalization
ASA at Arrival
X
X
X
X
ASA Prescribed @ Discharge
X
X
X
X
ACE Inhibitor (ACE-I) or Angiotensin Receptor Blocker (ARBs) Use for LVSD
ACE-I for LVSD
X
X
ACE-I or ARB for LVSD
X
X
Smoking Cessation
Smoking Cessation
    Counseling
X
X
X
X
Beta-Blocker Therapy
Β-blocker @ arrival
X
X
X
X
Β-blocker @ discharge
X
X
X
X
Β-blocker after heart attack
X
Persistence of Β-blocker
    Rx after heart attack
X
Hospital Arrival to Thrombolytic Therapy Time
Time to Thrombolysis
Time Interval <30 min.
X
X
X
X
Thrombolytic Given
     Anytime before PCI
X
Lipid-lowering Therapy and Cholesterol Management
Cholesterol Management
X2
Hospital AMI Mortality Rate (MR)
Inpatient AMI 30-day MR
X
X3
AMI InHospital MR
    with Transfer cases
X3
InHospital AMI MR
    without Transfer Cases
X3
Failure to Rescue
X3
AMI Diagnosed During or after non-cardiac surgery
AMI diagnosed Intra-op or
    <30 days after surgery
X
Hospital Measures for PCIs
PCI Volume
X
X
X5
PCI Mortality Rate4
X
X
X5
Hospital Measures for Primary PCI – Arrival to PCI (Door To Balloon) Times
Measured Time
X
Time Interval <90 min.
X
Time Interval <120 min.
X
X
X
Hospital CABG Surgery Measures
CABG Volume
X
X
X
CABG Mortality Rate6
X
X
X
CABG IMA Utilization Rate
X
X
CABG Utilization Rate –
    per 100,000 population
X
ACS / AMI - General Patient Safety Measures
Clinical Measure/Condition
NQF
AHRQ
Beta-Blocker Therapy
Β-blocker Prophylaxis for
    high-risk elective surgery
X
Β-blocker given to patient
    with CAD not on
    pre-op Β-blocker
X
Β-blocker given to patient
    on pre-op Β-blocker
X

1  NOT a Primary measure for ACS/AMI, but it is a primary measure for CHF.

2  Cholesterol Management in patients with cardiovascular conditions includes the percentage of ACS/AMI patients who had a low-density lipoprotein cholesterol (LDL-C) screening performed and the percentage of patients who have a documented LDL-C level less than 130 mg/dL and less than 100 mg/dL.

3  Premier uses risk-adjusted AMI mortality based on JCAHO hierarchical logistic regression methodology. AHRQ IQI uses two separate APR-DRG methodologies for the two AMI mortality measures. AHRQ PSIs include ‘Failure to rescue,’ which is not specific to AMI, but contributes to this measure. It is risk adjusted by DRG and other patient characteristics across multiple diagnostic groups.

4  PCI mortality is risk-adjusted by different methodologies for each entity. NQF Consensus Standards for Hospital Care uses the ACC-NCDR logistic regression model. COAP uses its own model.

5  The AHRQ IQI measures for PCIs do not include outpatient procedures since ICD-9-CM procedure codes were named as the HIPAA standard code set for inpatient hospital procedures only and not for other settings such as hospital outpatient services or other types of ambulatory services. Hospitals may capture the ICD-9-CM procedure codes for internally tracking or monitoring hospital outpatient services; but when conducting standard transactions, hospitals must use Healthcare Common Procedure Coding System (HCPCS) codes to report. The HCPCS Level 1 Code set include Current Procedure Terminology (CPT) codes that are maintained by the AMA.

6  CABG mortality is risk-adjusted by different methodologies for each entity. AHRQ IQIs utilizes an APR-DRG methodology. NQF Consensus Standards for Hospital Care uses the NY State Cardiac Surgery Reporting System's logistic regression model. COAP uses its own model.

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