VALUE BASED PURCHASING & CMS Reimbursement
The HACs are:
Foreign Object Retained After Surgery
Pressure Ulcer Stages III & IV
Falls and Trauma
Vascular Catheter-Associated Infections
Catheter-Associated Urinary Tract Infection (UTI)
Manifestations of Poor Glycemic Control
AHRQs Include Patient Safety
PSI 06-latrogenic pneumothorax adult
PSI 11-Post Operative Respiratory Failure
PSI 12-Post Operative PE or DVT
PSI 14-Post Operative Wound Dehiscence
PSI 15-Accidental puncture or laceration
IQI 11-Abdominal aortic aneurysm (AAA) repair mortality rate
IQI 19-Postoperative Hip Fracture
Complication/patient safety for selected indicators (composite)
Mortality for selected medical conditions (composite)
Here is a more detailed look at PSI 12 Post Operative Pulmonary Embolism or Deep Vein Thrombosis pulled straight from the Agency for Healthcare Research and Quality website http://www.ahrq.gov/qual/vtguide/vtguidechap4.htm
Key Metric 1: Prevalence of Appropriate Venous Thromboembolism Prophylaxis – Though Figure 3 was used earlier to understand care delivery, it can now be used to measure care delivery, as shown in Figure 4. Specifically, this diagram will assist in selecting metrics—meaningful and measurable steps the team can use to track performance over time. In most instances the most telling metric is the prevalence of appropriate prophylaxis. Not only does it have the most important causal relationship to the main clinical endpoint, hospital-acquired VTE, but it is also a sensitive indicator of how well the various care delivery steps come together.
Using the prevalence of appropriate VTE prophylaxis as one of the team’s two key metrics also offers something that can be measured regularly and reliably. Set up daily, weekly, or monthly data collection for this metric (go to Key Metric 2, below). This data flow offers a reliable way to track performance of the changed care delivery system. What makes the clinical endpoint of hospital-acquired VTE unsuitable as a lone metric for performance tracking is that events are too infrequent and are often sub-clinical or too delayed in onset for timely, useful feedback.
It should now be clear how the VTE protocol serves not just as the main ingredient for the improvement intervention but also for the measurement system that can track performance.
Key Metric 2: Incidence of Hospital-Acquired Venous Thromboembolism – The team cares most about how well the steps of care delivery come together to prevent hospital-acquired VTE, the main clinical endpoint or outcome. Clearly, the incidence of hospital-acquired VTE must be one of the team’s key metrics. A common definition for “hospital-acquired deep vein thrombosis or pulmonary embolism” would be a clot first discovered during the course of hospitalization or discovered within 30 days of a prior hospitalization.
AHRQs include Patient Safety Indicators (PSIs) & Inpatient Quality Indicators (IQIs)
For more information on these indicators download any of the following PDF’s.
- > Aetna
- > Blue Cross And Blue Shield Announces System
- > CMS - Propose Hospital ACQ Conditions 2009
- > Hosp Acqu Cond and Never Events Cost
- > Medicare Plan for Payments Irks Hospitals
- > MSPB Information
- > Patient Experience
- > Survey of Patient Hospital Experience
- > UHC Position on Never Events
- > Validity of Hospital Rankings