The Centers for Medicare and Medicaid Services have developed a core set of research-based quality indicators, which are being used across the nation. These agencies have established standardized measures of quality in selected patient populations including heart attack, community acquired pneumonia, heart failure and surgical site infection prevention.
Heart Attack: Also known as Acute Myocardial Infarction (AMI), heart attack is a leading cause of death and disability in the United States. Heart Attack clinical process indicators that are measured include:
- Aspirin given at hospital at the time of arrival (within 24 hours) and prescribed at discharge
- Beta-blocker medication within 24 hours of arrival
- Beta-blocker medications for continued treatment of a heart attack at discharge
- If indicated, an enzyme inhibiting drug (ACEI/ARB) is prescribed at discharge
- Smoking cessation counseling
Heart Failure: Like heart attack, heart failure is a leading cause of death and disability in the United States. This set of quality indicators includes key processes in care of patients with heart failure, and they are:
- If indicated, enzyme inhibiting drug (ACEI/ARB) is given for continued treatment of heart failure after discharge
- Advice for heart failure patients to stop smoking
- Testing that evaluates heart function
- Discharge education about heart failure and follow-up treatment
Pneumonia: Many people are susceptible to pneumonia due to their age or other health conditions. Pneumonia is both preventable and treatable and should not be a significant health concern. However, across the nation; it continues to be a problem leading to many days in the hospital and sometimes death. The quality indicators reported are:
- Assessing oxygen levels
- Pneumovax and influenza vaccination screening
- Pneumovax and influenza vaccination given during hospital stay for eligible patients
- Blood cultures obtained prior to giving antibiotics
- Appropriate antibiotic selection and timing (given within 4 hours of arrival)
- Smoking cessation counseling
Surgical Site Infection Prevention: It is important to track these measures when hospitals are working to reduce surgical site infections:
- Patients receive a preventative antibiotic one hour before incision
- Patients receive the appropriate antibiotics
- Preventive antibiotics are discontinued within 24 hours after surgery (48 hours after cardiac surgery)
- New infection prevention measures will soon be added to include:
- Appropriate hair removal (use of clippers)
- Maintaining a normal body temperature during surgery
- Maintaining good blood glucose (blood sugar) levels during surgery