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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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Page 179 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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Page 180 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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Page 181 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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Page 182 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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Page 183 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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Page 184 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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Page 185 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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Page 186 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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Page 187 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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Page 188 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.