Emergency Department Performance Measures

Transcription

1 Emergency Department Perfrmance Measures ACEP Clinical Emergency Data Registry () ACEP Campaign Centers fr Medicare and Medicaid Services (CMS) Medicare Beneficiary Quality Imprvement Prject (MBQIP) ED Perfrmance Measure by Categry ED Thrughput ED Median Time frm ED arrival t ED departure fr discharged ED patients - General Rate = (Overall Rate - Psych Pts - Transfer Pts), CMS ED Median Time frm ED arrival t ED departure fr discharged ED patients - Psych Mental Health Patients ED Median Time frm ED arrival t ED departure fr discharged ED patients - Transfer Patients Admit decisin time t emergency department departure time fr admitted patient CMS Dr t diagnstic evaluatin by a qualified medical prfessinal CMS, MBQIP, Left withut being seen MBQIP Chest Pain and Heart Attack Median time t transfer t anther facility fr acute crnary interventin CMS, MBQIP Median time t ECG CMS, MBQIP Fibrinlytic therapy received within 30 minutes f emergency department arrival CMS, MBQIP Timing f receipt f primary percutaneus crnary interventin (PCI) (<90 minutes gal) CMS Aspirin at arrival (heart attack) CMS, MBQIP Strke tpa Cnsidered: Percentage f patients aged 18 years and lder with a diagnsis f ischemic strke whse time frm symptm nset t arrival is less than 3 hurs wh were cnsidered fr t-pa administratin Head CT scan results fr acute ischemic strke r hemrrhagic strke wh received head CT scan interpretatin within 45 minutes f arrival CMS Apprpriate Imaging Avid cmputed tmgraphy (CT) scans f the head in emergency department patients with minr head injury wh are at lw risk based n validated decisin rules., Avid CT f the head in asymptmatic adult patients in the emergency department with syncpe, insignificant trauma and a nrmal neurlgical evaluatin. Avid CT pulmnary angigraphy in emergency department patients with a lw-pretest prbability f pulmnary emblism and either a negative Pulmnary Emblism Rule-Out Criteria (PERC) r a negative D-dimer.,

2 Avid rdering CT f the abdmen and pelvis in yung therwise healthy emergency department (ED) patients (age <50) with knwn histries f kidney stnes, r ureterlithiasis, presenting with symptms cnsistent with uncmplicated renal clic. MRI lumbar spine fr lw back pain CMS Thrax CT use f cntrast material CMS Abdmen CT use f cntrast material CMS Simultaneus use f brain cmputed tmgraphy (CT) and sinus CT CMS Apprpriate Antibitics Adult Sinusitis: Antibitic Prescribed fr Acute Sinusitis Adult Sinusitis: Apprpriate Chice f Antibitic: Amxicillin Prescribed fr Patients with Acute Bacterial Sinusitis Avidance f Antibitic Treatment in Adults with Acute Brnchitis Avid antibitics and wund cultures in emergency department patients with uncmplicated skin and sft tissue abscesses after successful incisin and drainage and with adequate medical fllw-up. Avid prescribing antibitics in the emergency department fr uncmplicated sinusitis. Initial antibitic fr cmmunity-acquired pneumnia (CAP) in immuncmpetent patient CMS Efficiency Cagulatin Studies in Patients Presenting with Chest Pain with N Cagulpathy r Bleeding Avid instituting intravenus (IV) fluids befre ding a trial f ral rehydratin therapy in uncmplicated emergency department cases f mild t mderate dehydratin in children. Three-day return rate fr ED visits Three-day return rate fr UC visits Other Pain Management fr Lng Bne Fracture MBQIP, CMS Anti-cagulatin fr Acute Pulmnary Emblism Patients Pregnancy Test fr Female Abdminal Pain Patients Tbacc Screening and Cessatin Interventin: Percentage f asthma and COPD patients aged 18 years and lder wh were screened fr tbacc use AND wh received cessatin cunseling interventin if identified as a tbacc user. Avid placing indwelling urinary catheters in the emergency department fr either urine utput mnitring in stable patients wh can vid, r fr patient r staff cnvenience Chsing Wisely Dn t delay engaging available palliative and hspice care services in the emergency. department fr patients likely t benefit. Bld cultures perfrmed in the emergency department prir t initial antibitic received in hspital CMS Emergency Department Transfer Cmmunicatin (EDTC) MBQIP

3 Pre-Transfer Cmmunicatin Infrmatin Patient Identificatin Vital Signs Medicatin-related Infrmatin Practitiner generated infrmatin Nurse generated infrmatin Prcedures and tests

4 ED Perfrmance Measure by Originating Organizatin Emergency Department Utilizatin f CT fr Minr Blunt Head Trauma fr Patients Aged 18 Years and Older Emergency Department Utilizatin f CT fr Minr Blunt Head Trauma fr Patients Aged 2 Thrugh 17 Years Cagulatin Studies in Patients Presenting with Chest Pain with N Cagulpathy r Bleeding Apprpriate Emergency Department Utilizatin f CT fr Pulmnary Emblism ED Median Time frm ED arrival t ED departure fr discharged ED patients - Overall Rate ED Median Time frm ED arrival t ED departure fr discharged ED patients - General Rate = (Overall Rate - Psych Pts- Transfer Pts) ED Median Time frm ED arrival t ED departure fr discharged ED patients - Psych Mental Health Patients ED Median Time frm ED arrival t ED departure fr discharged ED patients - Transfer Patients Dr t Diagnstic Evaluatin by a Qualified Medical Persnnel Anti-cagulatin fr Acute Pulmnary Emblism Patients Pregnancy Test fr Female Abdminal Pain Patients Three-day return rate fr ED visits Three-day return rate fr UC visits tpa Cnsidered: Percentage f patients aged 18 years and lder with a diagnsis f ischemic strke whse time frm symptm nset t arrival is less than 3 hurs wh were cnsidered fr t-pa administratin Tbacc Screening and Cessatin Interventin: Percentage f asthma and COPD patients aged 18 years and lder wh were screened fr tbacc use AND wh received cessatin cunseling interventin if identified as a tbacc user. Adult Sinusitis: Antibitic Prescribed fr Acute Sinusitis Adult Sinusitis: Apprpriate Chice f Antibitic: Amxicillin Prescribed fr Patients with Acute Bacterial Sinusitis Avidance f Antibitic Treatment in Adults with Acute Brnchitis Avid cmputed tmgraphy (CT) scans f the head in emergency department patients with minr head injury wh are at lw risk based n validated decisin rules. Avid placing indwelling urinary catheters in the emergency department fr either urine utput mnitring in stable patients wh can vid, r fr patient r staff cnvenience Chsing Wisely

5 Dn t delay engaging available palliative and hspice care services in the emergency. department fr patients likely t benefit. Avid antibitics and wund cultures in emergency department patients with uncmplicated skin and sft tissue abscesses after successful incisin and drainage and with adequate medical fllw-up. Avid instituting intravenus (IV) fluids befre ding a trial f ral rehydratin therapy in uncmplicated emergency department cases f mild t mderate dehydratin in children. Avid CT f the head in asymptmatic adult patients in the emergency department with syncpe, insignificant trauma and a nrmal neurlgical evaluatin. Avid CT pulmnary angigraphy in emergency department patients with a lw-pretest prbability f pulmnary emblism and either a negative Pulmnary Emblism Rule-Out Criteria (PERC) r a negative D-dimer. Avid prescribing antibitics in the emergency department fr uncmplicated sinusitis. Avid rdering CT f the abdmen and pelvis in yung therwise healthy emergency department (ED) patients (age <50) with knwn histries f kidney stnes, r ureterlithiasis, presenting with symptms cnsistent with uncmplicated renal clic. CMS Cre Measures Median time frm emergency department arrival t emergency department departure fr admitted emergency department patients CMS Admit decisin time t emergency department departure time fr admitted patient CMS Median time frm emergency department arrival t emergency department departure fr discharged emergency department patients CMS Dr t diagnstic evaluatin by a qualified medical prfessinal CMS Median time t pain medicatin fr lng bne fractures CMS Patient left withut being seen CMS Head CT scan results fr acute ischemic strke r hemrrhagic strke wh received head CT scan interpretatin within 45 minutes f arrival CMS Bld cultures perfrmed in the emergency department prir t initial antibitic received in hspital CMS Initial antibitic fr cmmunity-acquired pneumnia (CAP) in immuncmpetent patient CMS Median time t transfer t anther facility fr acute crnary interventin CMS Median time t ECG CMS Fibrinlytic therapy received within 30 minutes f emergency department arrival CMS Aspirin at arrival CMS Timing f receipt f primary percutaneus crnary interventin (PCI) (<90 mins gal) MRI lumbar spine fr lw back pain CMS Thrax CT use f cntrast material CMS

6 Abdmen CT use f cntrast material CMS Simultaneus use f brain cmputed tmgraphy (CT) and sinus CT CMS MBQIP Emergency Department Transfer Cmmunicatin (EDTC) MBQIP Pre-Transfer Cmmunicatin Infrmatin Patient Identificatin Vital Signs Medicatin-related Infrmatin Practitiner generated infrmatin Nurse generated infrmatin Prcedures and tests ED Chest Pain and Heart Attack OP-1: Median Time t Fibrinlysis in the Emergency Department MBQIP OP-2: Fibrinlytic Therapy Received Within 30 Minutes f ED Arrival in the Emergency Department MBQIP OP-3: Median Time t Transfer t anther Facility fr Acute Crnary Interventin in the Emergency Dept. MBQIP OP-5: Median Time t ECG in the Emergency Department MBQIP ED Thrughput OP-20: Dr t Diagnstic Evaluatin by a Qualified Medical Persnnel MBQIP OP-21: Pain Management fr Lng Bne Fracture MBQIP OP-22: Left withut being seen MBQIP