NCQA PCSP 2016 Quality Measurement and Improvement Worksheet
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1 PURPOSE: This worksheet is to help practices organize the measures and QI activities that are required by PCSP 6, Element C. Refer to PCSP 6, Elements A C for additional information. NOTE: Practices are not required to submit this worksheet as documentation; it is provided as an option. Practices may submit their own report detailing their QI strategy but should consult the QI Worksheet Instructions for guidance. QUALITY MEASUREMENT & IMPROVEMENT ACTIVITY STEPS 1. Identify measures for quality improvement. From PCSP 6, Elements A and B, identify: From Element A, factors 1 and 3: At least three clinical quality and/or utilization measures. From Element A, factor 2: At least one coordination measure. At least one measure focused on vulnerable populations with an identified health disparity (the measure may, but does not need to, be one identified in Element A, factor 4). From Element A, factor 5: At least one access measure. From Element B: At least one patient/family experience measure. 2. Identify a baseline performance assessment. Choose a starting measurement period (start and end date) and identify a baseline performance measurement for each measure. Use performance measurements from the reports provided in PCSP 6, Elements A B. The baseline measurement period must be within 12 months before tool submission or within 24 months, if there is a remeasurement period. The performance measurement must be a rate (percentage based on numerator and denominator) or number (with the number of patients represented by the data). 3. Establish a performance goal. Generate at least one performance goal for each identified measure. The specific goal must be a rate or number greater than the baseline performance assessment. Simply stating the practice intends to improve does not meet the objective. (Applies to 6C, 1 5.) Note for Multi-Sites: Organizational goals and actions for each site may be used if remeasurement and performance relate to the practice. Each practice must have its own baseline and performance results. 4. Determine actions to work toward performance goals. List at least one action for each identified measure and the activity start date. The action date must occur after the date of the baseline performance assessment date. You may list more than one activity but are not required to do so. (Applies to 6C, 1 5.) 5. Remeasure performance based on actions taken. Choose a remeasurement period and generate a new performance measurement after action was taken to improve. The remeasurement date must occur after the date of implementation and must be within 12 months before tool submission. The performance measurement must be a rate (percentage based on numerator and denominator) or number (with number of patients represented by the data). (Applies to 6C, 6 7.) Note: To receive credit for 6C, factors 8 9, the remeasurement must show improvement on at least two measures. 6. Assess actions taken and describe improvement. Briefly describe how your practice site showed improvement on measures. Describe the assessment of actions; correlate actions and the resulting improvement. (Applies to 6C, 6 7.)
2 EXAMPLE: HOW TO COMPLETE THE WORKSHEET Example: Clinical Measure Measure 1: Blood Pressure Control (<140/90 mm Hg) 1. Measure selected for measurement; numeric goal for improvement (6C 1) and work toward goal; dates of initiation (6C 1) (Only 1 5. Remeasure performance 6. Assess actions; describe improvement (6C 7) Half our patients have high BP (>140/90 mm Hg) and are at greater risk for stroke, kidney damage, heart and coronary artery damage, vision loss and other related health consequences. Baseline 1/1/15 Baseline 3/31/15 260/520 = 50% of patients have BP <140/90 mm Hg 75% Identified patients with BP >140/90 mm Hg; developed a multimodal outreach campaign for the target group, including greater compliance with medication and increased education about heart-healthy lifestyle options. 4/1/15 6/1/15 8/31/15 372/531 = 70% During a three-month measurement period (Jan 2015 Mar 2015), 50% of patients had a BP <140/90 mm Hg. After identifying patients with high BP, we developed an educational outreach plan of action and provided training to clinicians to incorporate identified strategies to lower patients BP. After implementing the outreach campaign, we saw a 20% increase in the number of patients with BP <140/90 mm Hg during the remeasurement period (June Aug 2015).
3 Example: Identify a Disparity in Care for a Vulnerable Population Vulnerable population: Uninsured women Disparity: Uninsured women receive fewer mammograms 1. Identify a disparity in care for a vulnerable population measurement and numeric goal for improvement (6C5) and work toward goal; dates of initiation (6C 2) (Only 1 5. Remeasure performance Note: Continuing QI is encouraged, but is not required to meet 6C Assess actions; describe improvement Note: Continuing QI is encouraged, but is not required to meet 6C 5. Describe a comparison of a vulnerable population against the general population in which the vulnerable population received care/service at a lower performance: Uninsured patients receive fewer mammograms than insured patients. Baseline 1/2015 Baseline 6/2015 Baseline Performance Measurement for Vulnerable Population (% or #): 25/100 = 25% of uninsured women receive mammograms Baseline Performance Measurement for General Population (% or #): 600/1,000 = 60% of insured women receive mammograms 50% of uninsured women receive mammograms Identified community resources for free or low-cost mammograms and shared with uninsured patients. 1/2016
4 Practice Name: Date Completed: Use THREE Measures Identified in 6A, factors 1 and/or 3 Measure 1: 1. Measure selected for for improvement. (6C 1) of initiation (6C 1) (Only 1 Baseline Baseline
5 Measure 2: 1. Measure selected for for improvement. (6C 1) of initiation (6C 1) (Only 1 Baseline Baseline
6 Measure 3: 1. Measure selected for for improvement. (6C 1) of initiation (6C 1) (Only 1 Baseline Baseline
7 Use ONE Measure Addressing Coordination With Primary Care Measure 1: 1. Measure selected for for improvement. (6C 2) of initiation (6C 2) (Only 1 Baseline Baseline
8 Use ONE Measure Addressing Patient Experience Identified in 6B Measure 1: 1. Measure selected for for improvement. (6C 3) of initiation (6C 3) (Only 1 Baseline Baseline
9 Use ONE Measure Addressing Patient Access Measure 1: 1. Measure selected for for improvement. (6C 4) of initiation (6C 4) (Only 1 Baseline Baseline
10 Identify a Disparity in Care for a Vulnerable Population Vulnerable population: Disparity: 1. Measure selected for for improvement. (6C 5) of initiation (6C 5) (Only 1 Note: Continuing QI is encouraged, but is not required to meet 6C 5. Describe a comparison of a vulnerable population against the general population in which the vulnerable population received care/service at a lower performance: Baseline Baseline Baseline Performance Measurement for Vulnerable Population (% or #): Baseline Performance Measurement for General Population (% or #): improvement. Note: Continuing QI is encouraged, but is not required to meet 6C 5.
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