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APPENDIX C
Submissions in Response to the IOM Committee's Call for Measures from the Private Sector1
Submitted by: |
Name of Measure |
Component of Health Care Quality |
Consumer Perspective on Health Care Needs |
American Diabetes Association (ADA) |
Percentage of patients receiving one or more glycohemoglobin (HbA1c) tests per year |
Effectiveness |
Living with illness |
ADA |
Percentage of patients with highest-risk HbA1c level (HbA1c greater than 9.5%) |
Effectiveness |
Living with illness |
ADA |
Percentage of patients assessed for nephropathy |
Effectiveness |
Living with illness |
ADA |
Percentage of patients receiving a lipid profile |
Effectiveness |
Living with illness |
ADA |
Percentage of patients with a low-density lipoprotein (LDL) less than 130 mg/dl |
Effectiveness |
Living with illness |
ADA |
Percentage of patients with blood pressure less than 140/90 mmHg |
Effectiveness |
Living with illness |
1 The committee issued its call for measures to the private sector from June to July, 2000. The Agency for Healthcare Research and Quality issued a separate call for measures to federal agencies after the committee had concluded its deliberations.
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ADA |
Percentage of patients receiving a dilated eye exam in the past year (or past two years if certain criteria are met) |
Effectiveness |
Living with illness |
ADA |
Percentage of patients with an annual foot exam |
Effectiveness |
Living with illness |
ADA |
Smoking cessation counseling |
Effectiveness |
Living with illness |
American Medical Association (AMA) |
Percentage of patients with diabetes receiving one or more HbA1c test(s) per year |
Effectiveness |
Living with illness |
AMA |
Percentage of patients with diabetes receiving at least one lipid profile per year |
Effectiveness |
Living with illness |
AMA |
Percentage of patients with diabetes who had any test for microalbuminuria per year |
Effectiveness |
Living with illness |
AMA |
Percentage of patients with diabetes receiving a dilated eye exam per year |
Effectiveness |
Living with illness |
AMA |
Percentage of patients with diabetes with at least one foot exam per year |
Effectiveness |
Living with illness |
AMA |
Percentage of patients with diabetes who received an influenza vaccine in the past year |
Effectiveness |
Living with illness |
AMA |
Percentage of patients with diabetes who had a blood pressure reading at each visit |
Effectiveness |
Living with illness |
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AMA |
Percentage of patients with diabetes with two or more visits per year |
Effectiveness |
Living with illness |
American Nurses Association (ANA) |
Patient satisfaction |
Patient centeredness |
Other |
ANA |
Mix of registered nurses, licensed practical nurses, and unlicensed assistive personnel in institutional settings |
Safety |
Getting better |
ANA |
Maintenance of skin integrity—prevention of nosocomial pressure ulcers. Percentage of patients with documented nosocomial ulcer on day of prevalence study |
Safety |
Getting better |
ANA |
Rate of patient falls and patient falls with injury. The rate per 1,000 patient-days at which patients fall and incur physical injury during their institutional stay |
Safety |
Getting better |
American Psychiatric Association (APA) |
Percentage of patients with a current diagnosis of chronic, moderate, or severe depression (not in remission) receiving an antidepressant medication or electroconvulsive therapy (ECT) |
Effectiveness |
Getting better |
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APA |
Percentage of patients with a current diagnosis of depression with psychotic features (not in remission) receiving either a combination of an antidepressant medication and an antipsychotic medication, or electroconvulsive therapy |
Effectiveness |
Getting better |
APA |
Percentage of patients with a current diagnosis of depression that is mild and not chronic (not in remission) receiving medication and/or psychotherapy |
Effectiveness |
Getting better |
Foundation for Accountability (FACCT) |
Adult asthma: patient education |
Effectiveness |
Living with illness |
FACCT |
Adult asthma: peak flow meter use |
Effectiveness |
Living with illness |
FACCT |
Adult asthma: appropriate inhaler use |
Effectiveness |
Living with illness |
FACCT |
Adult asthma: patient experience and satisfaction |
Patient centeredness |
Living with illness |
FACCT |
Adult asthma: patient self-management knowledge and behavior |
Effectiveness |
Living with illness |
FACCT |
Adult asthma: patient ability to maintain daily activities |
Effectiveness |
Living with illness |
FACCT |
Breast cancer: mammography |
Effectiveness |
Staying healthy |
FACCT |
Breast cancer: early-stage detection |
Timeliness |
Staying healthy |
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FACCT |
Breast cancer: informed about radiation treatment options |
Patient centeredness |
Living with illness |
FACCT |
Breast cancer: breast-conserving surgery |
Effectiveness |
Living with illness |
FACCT |
Breast cancer: radiation therapy following breast conserving surgery |
Effectiveness |
Living with illness |
FACCT |
Breast cancer: patient satisfaction with care |
Patient Centeredness |
Living with illness |
FACCT |
Breast cancer: experience of disease |
Effectiveness |
Living with illness |
FACCT |
Breast cancer: five-year disease-free survival |
Effectiveness |
Living with illness |
FACCT |
Diabetes: foot exam |
Effectiveness |
Living with illness |
FACCT |
Diabetes: frequency of HbA1c testing |
Effectiveness |
Living with illness |
FACCT |
Diabetes: retinal exam |
Effectiveness |
Living with illness |
FACCT |
Diabetes: advice to quit smoking |
Effectiveness |
Living with illness |
FACCT |
Diabetes: HbA1c under good control |
Effectiveness |
Living with illness |
FACCT |
Diabetes: lipid levels |
Effectiveness |
Living with illness |
FACCT |
Diabetes: smoking cessation |
Effectiveness |
Living with illness |
FACCT |
Diabetes: patient ability to maintain daily activities |
Effectiveness |
Living with illness |
FACCT |
Major depressive disorder: patient ability to maintain daily activities |
Effectiveness |
Living with illness |
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FACCT |
Health risks: advice to quit smoking |
Effectiveness |
Staying healthy |
FACCT |
Health risks: awareness of health habits |
Effectiveness |
Staying healthy |
FACCT |
Health risks: smoking cessation |
Effectiveness |
Staying healthy |
FACCT |
Adolescent preventive care: counseling and screening to prevent risky behaviors |
Effectiveness |
Staying healthy |
FACCT |
Adolescent preventive care: counseling and screening to prevent unwanted pregnancies and sexually transmitted diseases (STDs) |
Effectiveness |
Staying healthy |
FACCT |
Adolescent preventive care: counseling and screening related to diet, weight, and exercise |
Effectiveness |
Staying healthy |
FACCT |
Adolescent preventive care: counseling and screening related to depression, mental health, and relationships |
Effectiveness |
Staying healthy |
FACCT |
Adolescent preventive care: care provided in a confidential and private setting |
Effectiveness |
Staying healthy |
FACCT |
Adolescent preventive care: helpfulness of counseling provided |
Patient centeredness |
Staying healthy |
FACCT |
Adolescent preventive care: communication and experience of care |
Patient centeredness |
Staying healthy |
FACCT |
Early childhood development: getting anticipatory guidance from providers |
Patient centeredness |
Staying healthy |
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FACCT |
Early childhood development: follow-up for children with an indication of risk for developmental problems |
Effectiveness |
Staying healthy |
FACCT |
Early childhood development: communication and relationship with providers |
Patient centeredness |
Not specified |
FACCT |
Early childhood development: helpfulness and effect of anticipatory guidance and counseling on confidence as a parent |
Patient centeredness |
Not specified |
FACCT |
Children with chronic conditions: how well doctors communicate |
Patient centeredness |
Living with illness |
FACCT |
Children with chronic conditions: getting care quickly |
Timeliness |
Living with illness |
FACCT |
Children with chronic conditions: patient education and teamwork |
Patient centeredness, effectiveness |
Living with illness |
FACCT |
Children with chronic conditions: coordination of child's care |
Timeliness |
Living with illness |
FACCT–Robert Wood Johnson (RWJ) |
Health status and quality of life (6 measures) |
Effectiveness |
Not specified |
FACCT–RWJ |
Healthy life style (3 measures) |
Effectiveness |
Staying healthy |
FACCT–RWJ |
Self-care efficacy (1 measure) |
Patient centeredness |
Staying healthy |
FACCT–RWJ |
Risk reduction counseling (3 measures) |
Patient centeredness |
Staying healthy |
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FACCT–RWJ |
Getting needed care (2 measures) |
Timeliness |
Getting better |
FACCT–RWJ |
Medical home (2 measures) |
Timeliness |
Not specified |
FACCT–RWJ |
Access to specialized services (1 measure) |
Timeliness |
Getting better, living with illness |
FACCT–RWJ |
Consumer empowerment (2 measures) |
Patient centeredness |
Not specified |
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) |
AMI, HF, PN—smoking cessation advice counseling |
Effectiveness |
Getting better |
JCAHO |
AMI—aspirin at arrival |
Effectiveness |
Getting better |
JCAHO |
AMI—reperfusion therapy: time from arrival to initiation |
Effectiveness |
Getting better |
JCAHO |
AMI—aspirin at discharge |
Effectiveness |
Getting better |
JCAHO |
AMI—beta-blocker at arrival |
Effectiveness |
Getting better |
JCAHO |
AMI, HF—LVEF <40% prescribed ACEI at discharge |
Effectiveness |
Getting better |
JCAHO |
AMI—beta-blocker at discharge |
Effectiveness |
Getting better |
JCAHO |
AMI—intrahospital mortality |
Effectiveness |
Getting better |
JCAHO |
HF—patients with atrial fibrillation prescribed warfarin at discharge |
Effectiveness |
Getting better |
JCAHO |
HF—diet, weight, and medication management instructions at discharge |
Patient centeredness |
Living with illness |
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JCAHO |
HF—assessment of left ventricular function |
Effectiveness |
Getting better |
JCAHO |
PN—pneumonia screen or pneumococcal vaccination |
Effectiveness |
Staying healthy |
JCAHO |
PN—oxygenation assessment |
Effectiveness |
Getting better |
JCAHO |
PN—blood cultures |
Effectiveness |
Getting better |
JCAHO |
PN—antibiotic timing |
Timeliness |
Getting better |
JCAHO |
PN—empiric antibiotic regimen non-ICU |
Effectiveness |
Getting better |
JCAHO |
PN—empiric antibiotic regimen ICU |
Effectiveness |
Getting better |
JCAHO |
PR—vaginal birth after C-section (VBAC) rate |
Effectiveness |
Getting better |
JCAHO |
PR—third- or fourth-degree laceration |
Effectiveness |
Getting better |
JCAHO |
PR—neonatal mortality |
Effectiveness |
Other |
JCAHO |
SG—surgical site infection within 30 days (for selected surgical procedures) |
Safety |
Getting better |
JCAHO |
SG—timing of prophylactic administration of antibiotic |
Timeliness |
Getting better |
Pamela Mitchell (American Academy of Nursing) |
Patient fall injury rate |
Safety |
Getting better |
Pamela Mitchell |
Nosocomial infection (category of adverse events) (includes pneumonia and urinary tract infection in surgical patients; decubiti in all patients) |
Safety |
Getting better |
National Committee for Quality Assurance (NCQA)—HEDIS |
Effectiveness of care (16 measures) |
Effectiveness |
All |
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NCQA—HEDIS |
Access or availability of care (5 measures) |
Timeliness |
All |
NCQA—HEDIS |
Satisfaction with experience of care (2 sets of measures—HEDIS/CAHPS 2.0H) |
Patient centeredness |
Several |
NCQA—HEDIS |
Health plan stability (2 measures) |
Safety |
Several |
NCQA—HEDIS |
Use of services (17 measures) |
Not specified |
Several |
NCQA—HEDIS |
Informed health care choices (1 measure) |
Patient centeredness |
Staying healthy |
NCQA– HEDIS |
Health plan descriptive information (8 measures) |
NA |
NA |
Barbara Starfield |
Primary Care Assessment Tool (child edition, adult edition, provider edition) |
Effectiveness, patient centeredness |
Staying healthy, getting better, coping with the end of life |
U.S. Pharmacopoeia |
Patient safety and medication error reporting system (standardized Medication Error Index) |
Safety |
Getting Better |
NOTES: ACEI = angiotensin-converting enzyme inhibitor; AMI = Acute Myocardial Infarction Core Performance Measurement Set; CAHPS = Consumer Assessment of Health Plans Survey; HEDIS = Health Plan Employer Data and Information Set; HF = Heart Failure Core Performance Measurement Set; ICU = intensive care unit; LVEF = left ventricular ejection fraction; PN = Community-Acquired Pneumonia Core Performance Measurement Set; PR = Pregnancy and Related Conditions Core Performance Measurement Set; SG = Surgical Procedures and Complications Core Performance Measurement Set; VBAC = vaginal birth after cesarean section.