Year 6 Specifications- Clinical conditions and measures for
reporting and incentives
The CMS/Premier HQID Extension for Year 6 of the project includes quality measures based on clinical evidence and industry recognized metrics. The measures include:
- All required measures for Reporting Hospital Quality Data for Annual Payment Update.
- Where applicable, the project uses the National Hospital Quality Manual specifications.
- Ischemic Stroke measures are based on the specifications from The Joint Commission Primary Stroke Centers
Year 6 overview of measures
HQID test measures are required as part of the CMS/Premier HQID demonstration project extension. Test measures will not be submitted to CMS or subject to CDAC validation.
- Clinical conditions and measures effective October 1, 2008 to March 31, 2009 (.pdf)
- Clinical conditions and measures effective April 1, 2009 to September 30, 2009 (.pdf)
- Year 6 Measure Grid (.pdf)
Clinical
measure algorithm flowcharts by Focus Area
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The following files are zipped versions of all measures, see below for individual conditions.
v1 = Version 1: HQID Year 6 Discharges October 1, 2008 to March 31, 2009 (.zip)
v2= Version 2: HQID Year 6 Discharges April 1, 2009 to September 30, 2009
Current version is linked with each measure's name. If an older version exists, it will be linked to the right of the measure's name. If no version 2 is listed, there was no change from version 1 for that measure.
| Clinical conditions | Measures |
Acute Myocardial Infarction (AMI) |
1. Aspirin at arrival (v2) |
| 2. Aspirin prescribed at discharge (v2) | |
| 3. ACEI or ARB for left ventricular systolic dysfunction (LVSD) (v2) | |
| 4. Adult smoking cessation advice counseling (v2) | |
| 5. Beta-blocker prescribed at discharge (v2) | |
| 6. Beta-blocker at arrival Retired effective April 1, 2009 | |
| 7. Fibrinolytic therapy received within 30 minutes of hospital arrival (v2) | |
| 8. Primary percutaneous coronary intervention (PCI) received within 90 minutes of hospital arrival (v2) | |
| 9. Inpatient Mortality (v2) | |
Acute Myocardial Infarction (AMI) Test Measures
|
10. LDL cholesterol assessment (v2) |
| 11. Lipid lowering therapy at discharge (v2) | |
| 12. HQID (CMS) 30-day mortality rate | |
| 13. Premier readmission within 30 days | |
| 14. AHRQ patient safety composite measure | |
| 15. Appropriate care measure | |
| 16. CMS 30-day readmission rate (CMS administrative data) | |
| 17. CareScience complication measure | |
| 18. Risk-adjusted average length of inpatient hospital stay | |
Isolated Coronary Artery Bypass Graft (CABG) |
19. Aspirin prescribed at discharge (v2) |
| 20. Coronary artery bypass graft using internal mammary artery (IMA) (v1) | |
| 21. Prophylactic antibiotic received within 1 hour prior to surgical incision (v2) | |
| 22. Prophylactic antibiotic selection for isolated CABG patients (v2) | |
| 23. Prophylactic antibiotics discontinued within 48 hours after surgery end time (v2) (v1) | |
| 24. Cardiac surgery patients with controlled 6 a.m. postoperative blood glucose (v2) | |
| 25. Surgery patients on beta-blocker therapy prior to admission who received a beta-blocker during the perioperative period (v2) | |
| 26. Inpatient mortality rate | |
Isolated Coronary Artery Bypass Graft (CABG) Test Measures
|
27. Premier readmission to same facility within 30 days of discharge |
| 28. AHRQ patient safety composite measure | |
| 29. Appropriate care measure | |
| 30. AHRQ inpatient quality indicator post-procedural mortality - CABG | |
| 31. CareScience complication measure | |
| 32. Risk-adjusted average length of inpatient hospital stay | |
Heart Failure (HF)
|
33. Evaluation of LVS Function (LVF Assessment) (v2) |
| 34. ACEI or ARB for left ventricular systolic dysfunction (LVSD) (v2) | |
| 35. Discharge Instructions (v1) | |
| 36. Adult smoking cessation advice counseling (v1) | |
Heart Failure (HF) Test Measures
|
37. Premier readmission to same facility within 30 days of discharge |
| 38. AHRQ patient safety composite measure | |
| 39. Appropriate care score | |
| 40. HQID (CMS) 30-day mortality rate | |
| 41. AHRQ inpatient quality indicators in-hospital mortality rate – Heart failure | |
| 42. CMS 30-day readmission rate | |
| 43. CareScience complication measure | |
| 44. Risk-adjusted average length of inpatient hospital stay | |
Pneumonia (PN) |
45. Oxygenation assessment - Retired effective January 1, 2009 |
| 46. Initial antibiotic selection for community acquired pneumonia in immuno-competent patients (v2) | |
| 47. Blood cultures performed in the emergency department prior to initial antibiotic received in hospital (v2) | |
| 48. Influenza vaccination (v2) | |
| 49. Pneumococcal vaccination (v2) | |
| 50. Initial antibiotic received within 6 hours of hospital arrival (v2) | |
| 51. Adult smoking cessation advice/counseling (v2) | |
Pneumonia (PN) Test Measures |
52. Premier readmission to same facility within 30 days of discharge |
| 53. AHRQ patient safety composite measure | |
| 54. Appropriate care measure | |
| 55. HQID (CMS) 30-day mortality rate | |
| 56. AHRQ inpatient quality indicators in-hospital mortality – Pneumonia | |
| 57. CMS 30-day readmission rate | |
| 58. CareScience complication measure | |
| 59. Risk-adjusted average length of inpatient hospital stay | |
Hip and Knee Replacement |
60. Prophylactic antibiotic received within one hour prior to surgical incision (v2) |
| 61. Prophylactic antibiotic selection for hip and knee replacement patients (v2) | |
| 62. Prophylactic antibiotics discontinued within 24 hours after surgery end time (v2) | |
| 63. Hip or Knee replacement patients with recommended venous thromboembolism (VTE) prophylaxis ordered (v2) | |
| 64. Hip or Knee replacement patients who received appropriate VTE prophylaxis within 24 hours prior to surgery to 24 hours after surgery(v2) | |
| 65. Hip or Knee replacement patients on beta-blocker therapy who received beta-blocker during perioperative period. (v2) | |
| 66. CMS readmission within 30 days post discharge to any acute care facility | |
Hip and Knee Replacement Test Measures
|
67. AHRQ patient safety composite measure |
| 68. Appropriate care measure | |
| 69. AHRQ inpatient quality indicator post-procedural mortality – Hip or knee replacement | |
| 70. CareScience complication measure | |
| 71. Risk-adjusted average length of inpatient hospital stay | |
Surgical Care Improvement Project (SCIP) |
72. Prophylactic antibiotic received within one hour prior to surgical incision (v2) |
| 73. Prophylactic antibiotic selection for surgical patients (v2) | |
| 74. Prophylactic antibiotics discontinued within 24 hours after surgery end time (v2) | |
| 75. Surgery patients with recommended VTE prophylaxis ordered (v2) | |
| 76. Surgery patients who received appropriate VTE prophylaxis within 24 hours prior to surgery to 24 hours after surgery (v2) | |
| 77. Cardiac surgery patients with controlled 6 a.m. postoperative blood glucose (v2) | |
| 78. Surgery patients with appropriate hair removal (v2) | |
| 79. Colorectal surgery patients with immediate postoperative normothermia (v2) | |
| 80. Surgery patients on beta-blocker therapy prior to admission who received a beta-blocker during the perioperative period (v2) | |
Surgical Care Improvement Project (SCIP) Test Measure |
81. CareScience complication measure |
| 82. Risk-adjusted average length of inpatient hospital stay | Ischemic Stroke Test Measures |
83. Deep vein thrombosis (DVT) prophylaxis (v1) |
| 84. Discharges on antithrombotic therapy (v1) | |
| 85. Patients with atrial fibrillation receiving anticoagulation therapy (v1) | |
| 86. Thrombolytic therapy administered (v1) | |
| 87. Antithrombotic therapy by end of hospital day two (v1) | |
| 88. Discharged on cholesterol reducing medication (v1) | |
| 89. Dysphagia screening (v1) | |
| 90. Smoking cessation advice/counseling (v1) | |
| 91. Risk-adjusted average length of inpatient hospital stay | |
HCAHPS Test Measure |
Composite of Hospital Consumer Assessment of Healthcare Providers and Systems measures |
Flowchart appendices year 6 v2 (.zip): Includes ICD-9-CM codes, medications and miscellanous tables. v1 (.zip)