Chief Complaint–Based Performance Measures: A New Focus for Acute Care Quality Measurement

Griffey, Richard T.; Pines, Jesse M.; Farley, Heather; Phelan, Michael; Beach, Christopher; Schuur, Jeremiah D.; Venkatesh, Arjun K.

doi:10.1016/j.annemergmed.2014.07.453

Cited by 42 publications

(47 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More specific automated quality metric calculation has been reported for SCIP-VTE-2 (deep venous thrombosis) with an accuracy of 96.3% [23] . Measurement concepts have been proposed for automated calculation of American College of Emergency Physicians Quality Metrics basing on availability of variables [24] . EHR-based automated calculation of 12 "meaningful use" quality metrics for more than 100 …”

Section: Discussionmentioning

confidence: 99%

Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use

Dziadzko¹,

Ahmed²,

Tiong³

et al. 2016

WJCCM

View full text Add to dashboard Cite

AIM:To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit (ICU). METHODS:This minimal risk observational study was performed at an academic tertiary hospital. The Critical Care Independent Multidisciplinary Program at Mayo Clinic identified and defined 11 key quality metrics. These metrics were automatically calculated using ICU DataMart, a near-real time copy of all ICU electronic medical record (EMR) data. The automatic report was compared with data from a comprehensive EMR review by a trained investigator. Data was collected for 93 randomly selected patients admitted to the ICU during April 2012 (10% of admitted adult population). This study was approved by the Mayo Clinic Institution Review Board. RESULTS:All types of variables needed for metric calculations were found to be available for manual and electronic abstraction, except information for availability of free beds for patient-specific time-frames. There was 100% agreement between electronic and manual data abstraction for ICU admission source, admission service, and discharge disposition. The agreement between electronic and manual data abstraction of the time of ICU admission and discharge were 99% and 89%. The time of hospital admission and discharge were similar for both the electronically and manually abstracted datasets. The specificity of the electronically-generated report was 93% and 94% for invasive and non-invasive ventilation use in the ICU. One false-positive result for each type of ventilation was present. The specificity for ICU and in-hospital mortality was 100%. Sensitivity was 100% for all metrics. CONCLUSION:Our study demonstrates excellent accuracy of electronically-generated key ICU quality metrics. This validates the feasibility of automatic metric generation. Core tip: Meaningful use of electronic healthcare records (EHRs) requires quality measures. Many administrative reporting tools provided by current EHRs are based on insufficiently accurate data and thus of limited use. We examine the feasibility and the validity of electronic generation of institutional key intensive care unit (ICU) quality metrics using ICU DataMart, a near-real time relational database.Dziadzko MA, Thongprayoon C, Ahmed A, Tiong IC, Li M, Brown DR, Pickering BW, Herasevich V. Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use.

show abstract

Section: Discussionmentioning

confidence: 99%

Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use

Dziadzko¹,

Ahmed²,

Tiong³

et al. 2016

WJCCM

View full text Add to dashboard Cite

show abstract

“…We now have ED-based fellowships, emerging funding streams, and discussions in the highest levels of EM literature about measurement of quality in the care of our patients. 12 Other specialties are investigating novel approaches to incentivize faculty participation in resident quality improvement projects, such as providing maintenance of certification credit, which could easily be adapted to our specialty. 13 Any future work into designing EM research requirements should be flexible enough to allow for emerging and important areas of investigation such as this.…”

Section: Discussionmentioning

confidence: 99%

A National Evaluation of the Scholarly Activity Requirement in Residency Programs: A Survey of Emergency Medicine Program Directors

Geyer

Kaji

Katz

et al. 2015

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The Review Committee for Emergency Medicine (RC-EM) requirement for scholarly activity, which programs may define as an original research project or some other form of scholarly activity, applies to all EM residents. The objectives of this study were to: 1) describe the percentage of residency programs that require an original research project to meet the RC-EM requirement for scholarly activity, 2) describe specific challenges and resources for residents completing the RC-EM scholarly activity requirement, and 3) identify associations between the interpretation of the requirement and early career outcomes.Methods: This was a cross-sectional online survey of program or research directors from all U.S. allopathic EM residency programs. Respondents were queried about key demographics and domains relating to research curriculum, resources, expectations, outcomes, challenges, and future opportunities. Data were analyzed using descriptive statistics.Results: The overall response rate was 113 of 156 (72%) EM residency programs. Respondents were more likely to represent university-based programs, but otherwise did not differ from nonrespondents across key demographic criteria. An original research project was required by 39% of responding programs, with a minimum deliverable in 93% of these programs. Program directors listed data collection and study design as the principle challenges residents face while completing their scholarly activities. Faculty mentorship, biostatistical support, and travel support were common resources reportedly available to residents. Comparison of programs with an original research requirement to those without revealed many differences in outcomes. Programs with a research requirement were more likely to have residents with oral or poster presentations (46% vs. 25%, mean difference = 21%, 95% confidence interval [CI] = 16% to 28%), published manuscripts (25% vs. 18%, mean difference = 7%, 95% CI = 2% to 10%), entering fellowship training after residency (27% vs. 20%, mean difference = 7%, 95% CI = 4% to 10%), and using a biostatistician (64% vs. 28%, median difference = 26%, 95% CI = 24% to 28%). There were no statistically significant differences in other evaluations of resources or outcome measures, including resident choice of academic career after leaving residency.Conclusions: There is no consistent interpretation and implementation of the RC-EM requirement for scholarly activity among EM residency programs. Residency programs requiring an original research project were more likely to have residents with accepted oral or poster presentations, published manuscripts, and entering fellowships after residency training.

show abstract

“…Imaging metrics should group ED patients with similar complaints together, such as abdominal pain; however, there is no common system for comparing patients with a chief complaint of abdominal pain because no universal categorization system exists for chief complaints, and it is not routinely collected in administrative databases. 11 Most metrics have been developed using diagnosis codes rather than chief complaint as the denominator for quality measures, which limits their utility.…”

Section: Physician Professional Society Efforts To Measure Imaging Qumentioning

confidence: 99%

“…When considering new quality measures, it is important to keep in mind clinical relevance, the feasibility of collecting necessary data, and the ultimate reliability and validity of the measure. 11,12 The validity of a performance measure refers to the extent to which it truly measures that which it is intended and designed to measure. Reliability refers to "the stability of a set of observations generated by an indicator under a fixed set of conditions, regardless of who collects the observations or of when or where they are collected," 15 and is a scientific attribute of measurement instruments.…”

Section: Physician Professional Society Efforts To Measure Imaging Qumentioning

confidence: 99%

Policy Measures and Reimbursement for Emergency Medical Imaging in the Era of Payment Reform: Proceedings From a Panel Discussion of the 2015 Academic Emergency Medicine Consensus Conference

Berdahl

Schuur

Fisher

et al. 2015

Academic Emergency Medicine

Self Cite

View full text Add to dashboard Cite

The Affordable Care Act (ACA) of 2010 is expanding the use of quality measurement and promulgating new payment models that place downward pressure on health care utilization and costs. As emergency department (ED) computed tomography utilization has tripled in the past decade, stakeholders have identified advanced imaging as an area where quality and efficiency measures should expand. On May 12, 2015, Academic Emergency Medicine convened a consensus conference titled “Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization.” As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the ACA and other quality programs on ED diagnostic imaging, specifically the way that quality metrics may affect ED care and how ED diagnostic imaging fits in the broader strategy of the U.S. government. This article discusses the content of the panel’s presentations.

show abstract

Chief Complaint–Based Performance Measures: A New Focus for Acute Care Quality Measurement

Cited by 42 publications

References 36 publications

Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use

Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use

A National Evaluation of the Scholarly Activity Requirement in Residency Programs: A Survey of Emergency Medicine Program Directors

Policy Measures and Reimbursement for Emergency Medical Imaging in the Era of Payment Reform: Proceedings From a Panel Discussion of the 2015 Academic Emergency Medicine Consensus Conference

Contact Info

Product

Resources

About