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CMS: Added measures for FY 2009-2010 reporting period

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The Centers for Medicare & Medicaid Services (CMS): is proposing to add 43 new measures for the FY 2009 reporting period, and to retire one existing measure. However, for some of the new measures, the hospitals will not have to affirmatively report data to CMS. Instead, CMS will calculate them from administrative data. If the proposals are adopted, the total number of measures for reporting for FY 2010 would be 72.

New Measures:

A. Surgical Care Improvement Project (SCIP) Measure (1):

  • SCIP Cardiovascular 2, surgery patients on a beta blocker prior to arrival who received a beta blocker during the perioperative period

B. Re-admission Measures (3):

  • Pneumonia (PN) 30 ‑ day risk standardized re-admission measure (Medicare patients)
  • Heart attack (AMI) 30 ‑ day risk standardized re-admission measure (Medicare patients)
  • Heart failure (HF) 30 ‑ day risk standardized re-admission measure (Medicare patients)

C. Nursing Sensitive Measure (4):

  • Failure to rescue
  • Pressure ulcer prevalence and incidence by severity
  • Patient falls prevalence
  • Patient falls with injury

D. AHRQ Patient Safety and Inpatient Quality Indicator Measures (9):

Patient Safety Indicators (PSIs)

  • PSI 4-Death among surgical patients with treatable serious complications
  • PSI 6-Iatrogenic pneumothorax, adult
  • PSI 14-Postoperative wound dehiscence
  • PSI 15-Accidental puncture or laceration

Inpatient Quality Indicators (IQIs)

  • IQI 4 – Abdominal aortic aneurysm (AAA) mortality rate (with volume)
  • IQI 11- AAA mortality rate (without volume)
  • IQI 19-Hip fracture morality rate
  • IQI – Mortality for selected medical conditions (composite)
  • IQI – Mortality for selected surgical procedures (composite)
  • IQI – Complication/patient safety for selected indicators (composite)

E. Venous Thromboembolism Measures (VTEs):

  • VTE-1: VTE prophylaxis
  • VTE-2: VTE prophylaxis in the ICU
  • VTE-4: Patients with overlap in anticoagulation therapy
  • VTE-5/6: (as combined measure) patients with UFH dosages who have platelet count monitoring and adjustment of medication per protocol or nomogram
  • VTE-7: Discharge instructions to address: follow-up monitoring, compliance, dietary
  • restrictions, adverse drug reactions/interactions

  • VTE-8: Incidence of preventable VTE

F. Stroke Measures (STK)

  • STK-1 DVT prophylaxis
  • STK-2 Discharged on antithrombotic therapy
  • STK-3 Patients with atrial fibrillation receiving anticoagulation therapy
  • STK-5 Antithrombotic medication by end of hospital day two
  • STK-7 Dysphasia screening

G. Cardiac Surgery Measures

  • Participation in a systematic database for cardiac surgery
  • Pre-operative beta blockade
  • Prolonged intubation
  • Deep sternal wound infection rate
  • Stroke/CVA
  • Post-operative renal insufficiency
  • Surgical re-exploration
  • Anti-platelet medication at discharge
  • Beta blockade therapy at discharge
  • Anti-lipid treatment at discharge
  • Risk-adjusted operative mortality for CABG
  • Risk-Adjusted Operative Mortality for Aortic Valve Replacement
  • Risk-adjusted operative mortality for mitral valve replacement/repair
  • Risk-adjusted mortality for mitral valve replacement and CABG surgery
  • Risk-adjusted mortality for aortic valve replacement and CABG surgery

Press Release:

Proposed Rule:
CMS released a Hospital Inpatient Rule for fiscal year 2009

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