Quality improvement in neurology

Sico, Jason J.; Sarwal, Aarti; Benish, Sarah E.; Busis, Neil A.; Cohen, Bruce H.; Das, Rohit R.; Finsilver, Shari; Halperin, John J.; Kelly, Adam G.; Meunier, Lisa; Phipps, Michael; Villanueva, Raissa; Gaudecker, Jane von; Bennett, Amy; Shenoy, Anant M.

doi:10.1212/wnl.0000000000009525

Cited by 7 publications

(9 citation statements)

References 25 publications

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“…12 This AANI-developed measure captures the percentage of patients who reported a fall during the measurement period and had a plan of care documented.Quality of Life for Patients With Neurologic Conditions. 13 This AANI-developed measure utilizes the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health-10 to capture the percentage of patients whose quality-of-life assessment results are maintained or improved during the measurement period.Patients Screened or Treated for Depression. The work group reports that depression screening and treatment is of value and notes the following measures are approved for use in the 2021 Performance Year by Centers for Medicare & Medicaid Services (CMS) in the Merit-based Incentive Payment System.…”

Section: Resultsmentioning

confidence: 99%

“…Quality of Life for Patients With Neurologic Conditions 13. This AANI-developed measure utilizes the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health-10 to capture the percentage of patients whose quality-of-life assessment results are maintained or improved during the measurement period.c Patients Screened or Treated for Depression.…”

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confidence: 99%

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Polyneuropathy Quality Measurement Set

et al. 2022

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Peripheral neuropathy affects ;5% of the population and diabetes is the most common cause. 1 Diabetic neuropathy often leads to pain, but clinicians do not always address neuropathic pain with their patients. 1,2 Given the effect of painful diabetic neuropathy (PDN) on patients' quality of life, appropriate treatment of this prevalent condition is essential. 1 To increase the delivery of effective management for patients with PDN, the American Academy of Neurology Institute (AANI) published a guideline on the treatment of PDN in 2011, and recently updated this guideline. 1The AANI also provides quality measures for individual physicians and clinicians, as well as treatment teams or practices to implement. The AANI's "Practice guideline update: Oral and topical treatment of painful diabetic polyneuropathy" posed a unique opportunity to simultaneously develop quality measures that could quantify how often guideline statements are implemented in practice while also evaluating potential new quality measures that would directly track patient care and outcomes. 1 Based on a meta-analysis, the practice guideline revealed that the medication classes with the highest efficacy for PDN are gabapentinoids, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and sodium channel blockers. 1 Furthermore, topical, nontraditional, and nonpharmacologic interventions are available. 1 Based on the considerable potential harms of opioids, the guideline recommends against starting opioids, including tramadol and tapentadol, for PDN, and recommends offering the option of a safe taper off opioids for those already taking them. 1 In concert with this guideline, the AANI formed a multidisciplinary work group tasked with identifying and developing process measures whose specifications stemmed from the updated diabetic neuropathy guideline statements as well as potential outcome measures that could apply to all polyneuropathy populations, not limited to diabetic neuropathy. These measures complement the AANI's distal symmetric polyneuropathy quality measurement set, which was released in 2014 and reaffirmed in 2019, and are not meant to be comprehensive measures reflecting all of the important aspects of the care of patients with polyneuropathy. 3

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confidence: 99%

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Polyneuropathy Quality Measurement Set

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“…However, studies are necessary to validate the usefulness of these particular scales/instruments in this context. Because the Centers for Medicare & Medicaid Services intends to shift the quality measures included in the QPP MIPS to outcome measures, 26 future updates to this measurement set will need to focus on generating appropriate outcome measures. In the meantime, the updates presented here should enhance compliance and drive improvement in the quality of care for individuals with PD.…”

Section: Discussionmentioning

confidence: 99%

Quality Improvement in Neurology

et al. 2021

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“…55 Policy efforts have emphasized the need for more integrated models of care delivery, in order to anticipate and address the varied psychosocial as well as physiologic effects of dementia on patients and families. 56,57 As one related development, Medicare has introduced Chronic Care Management billing codes to incentivize care coordination activities beyond face-to-face office visits, such as medication reconciliation, communications with specialists, coordination with home- and community-based service providers, and care planning. However, it remains unclear whether many practices will be able to take advantage of these payments.…”

Section: Contextual Issuesmentioning

confidence: 99%

Ethical Considerations in Dementia Diagnosis and Care

et al. 2021

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Alzheimer disease and other dementias present unique practical challenges for patients, their families, clinicians, and health systems. These challenges reflect not only the growing public health effect of dementia in an aging global population, but also more specific ethical complexities including early loss of patients' capacity to make decisions regarding their own care, the stigma often associated with a dementia diagnosis, the difficulty of balancing concern for patients' welfare with respect for patients' remaining independence, and the effect on the physical, emotional, and financial well-being of family caregivers. Caring for patients with dementia requires respecting patient autonomy while acknowledging progressively diminishing decisional capacity and continuing to provide care in accordance with other core ethical principles (beneficence, justice, and nonmaleficence). Whereas these ethical principles remain unchanged, neurologists must reconsider how to apply them given changes across multiple domains including our understanding of disease, clinical and legal tools for addressing manifestations of illness, our expanding awareness of the crucial role of family caregivers in providing care and maintaining patient quality of life, and societal conceptions of dementia and individuals' personal expectations for aging. This revision to the American Academy of Neurology's 1996 position statement summarizes ethical considerations that often arise in caring for patients with dementia; although it addresses how such considerations influence patient management, it is not a clinical practice guideline.

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Quality improvement in neurology

Cited by 7 publications

References 25 publications

Polyneuropathy Quality Measurement Set

Polyneuropathy Quality Measurement Set

Quality Improvement in Neurology

Ethical Considerations in Dementia Diagnosis and Care

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