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Quality Improvement Initiatives in Healthcares

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Instructions: Discuss the measures from the list below that must be implemented in a physician practice to improve patient outcomes

Anti-Depressant Medication Management (AMM)

  • Assesses adults 18 years of age and older with a diagnosis of major depression who were newly treated with antidepressant medication and remained on their antidepressant medications.
  • Two rates are reported:
    • Effective Acute Phase Treatment: Adults who remained on an antidepressant medication for at least 84 days (12 weeks).
    • Effective Continuation Phase Treatment: Adults who remained on an antidepressant medication for at least 180 days (6 months).

Cervical Cancer Screening:

  • Assesses women 21–64 years of age who were screened for cervical cancer using either of the following criteria:
    • Women age 21–64 who had cervical cytology performed every 3 years.
    • Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years.

Colorectal Screening:

  • Assesses adults 50–75 who had appropriate screening for colorectal cancer with any of the following tests: annual fecal occult blood test, flexible sigmoidoscopy every 5 years, colonoscopy every 10 years, computed tomography colonography every 5 years, stool DNA test every 3 years.

Hypertension/Cardiovascular:

  • Assesses patients who were hospitalized and discharged alive after an acute Myocardial Infarction (heart attack) who received treatment with beta-blockers for six months after discharge.
  • Assesses patients 18 to 85 with a diagnosis of hypertension whose most recent blood pressure reading was controlled.
    • Age 18 to 59 whose BP was <140/90
    • Age 60 to 85 with a diagnosis of diabetes whose BP was <140/90
    • Age 60 to 85 without a diagnosis of diabetes whose BP was <150/90

Immunization Status:

  • Adolescents: Assesses adolescents 13 years of age who had one dose of meningococcal vaccine, one Tdap vaccine and the complete human papillomavirus vaccine series by their 13th birthday.
  • Children: Assessed the percentage of children 2 years of age who had a four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (HepB), one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday.

Mammograms:

  • Women age 50 to 74 years who have had a mammogram during the preceding 24 months. Exclusion of those women who have undergone bilateral mastectomy.

Non- Recommended PSA:

  • Assess whether men 70 years of age and older were screened unnecessarily for prostate cancer using prostate-specific antigen (PSA)-based screening.

Osteoporosis Testing and Management in Older Women:

  • Osteoporosis Testing in Older Women: This survey-based measure assesses women 65–85 years of age who report ever having received a bone density test to check for osteoporosis.
  • Osteoporosis Management in Women Who Had a Fracture: Assesses women 65–85 years of age who suffered a fracture and who had either a bone mineral density test or a prescription for a drug to treat osteoporosis in the six months after the fracture.

Persistence of Beta Blocker treatment after a Heart Attack (BPH):

  • Assesses adults 18 years of age and older during the measurement year who were hospitalized and discharged alive with a diagnosis of acute myocardial infarction and who received persistent beta-blocker treatment for six months after discharge.

Smoking Cessation:

  • Assesses current smokers seen by a physician during the year who were advised to quit, and cessation medications were recommended and discussed. Different cessation methods were discussed.

Weight Assessment:

  • Assessed patients between the ages of 3 to 17 who had been examined for body mass index (BMI, received counseling on nutrition). Counseling or referral for physical activity or indication physical activity was addressed during an outpatient visit either by a claim or as a medical record entry during the measurement year.
  • Assesses the percentage of members 18–74 years of age who had an outpatient visit and whose body mass index (BMI) was documented during the measurement year or the year prior to the measurement year.
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