On July 1, 2011, performance on clinical quality and patient
experience measures began directly impacting the bottom line of
hospitals across the country through Medicare's Hospital Inpatient
Value-Based Purchasing (HVBP) Program.
The HVBP Program measures in FY 2013 focus on how closely hospitals
follow best clinical practices and how well hospitals enhance patients'
experiences of care. In the future, CMS plans to add additional
outcomes measures that focus on improved patient outcomes and
prevention of hospital-acquired conditions. Measures that have reached
very high compliance scores would likely be replaced, continuing to
raise the quality bar.
The measures for FY 2013 have been endorsed by national bodies of
experts, including the National Quality Forum. All measures adopted for
use in the HVBP Program are also included on Hospital
of Care Domains - weighted 70%
Percent of Heart Attack Patients Given Fibrinolytic Medication Within
30 Minutes Of Arrival
can cause heart attacks. Doctors may give this medicine, or perform a
procedure to open the blockage, and in some cases, may do both.
AMI-8: Percent of Heart
Attack Patients Given PCI Within 90 Minutes Of
The procedures called Percutaneous
Coronary Interventions (PCI) are among those that are the most
effective for opening blocked blood vessels that cause heart attacks.
Doctors may perform PCI, or give medicine to open the blockage, and
in some cases, may do both.
Percent of Heart Failure Patients Given Discharge
The staff at
the hospital should provide you with information to help you manage your
heart failure symptoms when you are discharged.
PN-3b: Percent of
Pneumonia Patients Whose Initial Emergency Room Blood Culture Was
Performed Prior To The Administration Of The First Hospital Dose Of
A blood culture tells what kind of
medicine will work best to treat your pneumonia.
Initial Antibiotic Selection for CAP in Immunocompetent
are medicines that treat infection, and each one is different. Hospitals
should choose the antibiotics that best treat the infection type for
each pneumonia patient.
Antibiotic Received Within One Hour Prior to Surgical
Getting an antibiotic within one
hour before surgery reduces the risk of wound infections. This
measure shows how often hospital staff make sure surgery patients get
antibiotics at the right time.
SCIP-Inf-2: Prophylactic Antibiotic
Selection for Surgical Patients
antibiotics work better than others to prevent wound infections for
certain types of surgery. This measure shows how often hospital staff
make sure patients get the right kind of preventive antibiotic
medication for their surgery.
Antibiotics Discontinued Within 24 Hours After Surgery End
Taking preventive antibiotics for
more than 24 hours after routine surgery is usually not necessary.
This measure shows how often hospitals stopped giving antibiotics to
surgery patients when they were no longer needed to prevent surgical
SCIP-Inf-4: Cardiac Surgery Patients with
Controlled 6AM Postoperative Serum Glucose
surgery patients get their blood sugar checked after surgery. Any
patient who has high blood sugar after heart surgery has a greater
chance of getting an infection. This measure tells how often the
blood sugar of heart surgery patients was kept under good control in
the days right after their surgery.
Patients on a Beta Blocker Prior to Arrival That Received a Beta
Blocker During the Perioperative Period
Many people who have heart
problems or are at risk for heart problems take drugs called beta
blockers to reduce the risk of future heart problems. This measure
shows whether surgery patients who were already taking beta blockers
before coming to the hospital were given beta blockers during the
time period just before and after their surgery.
SCIP-VTE-1: Surgery Patients with
Recommended Venous Thromboembolism Prophylaxis
of surgery can increase patients' risk of having blood clots after
surgery. For these types of surgery, this measure tells how often
treatment to help prevent blood clots was ordered by the
Patients Who Received Appropriate Venous Thromboembolism Prophylaxis
Within 24 Hours Prior to Surgery to 24 Hours After
This measure tells how often
patients having certain types of surgery received treatment to
prevent blood clots in the period from 24 hours before surgery to 24
hours after surgery.
Assessment of Healthcare Providers and Systems(HCAHPS survey) -
Experience of Care
A random sample
of patients discharged from hospitals across the country are surveyed
and asked questions about their feelings and perceptions about their
hospital stay. This measure combines hospital performance on
questions that asked patients their levels of satisfaction with some
of the following elements of their stay:
- How well nurses communicated with patients
- How well doctors communicated with patients
- How responsive hospital staff were to patients'
- How well caregivers managed patients' pain
- How well caregivers explained patients'
medications to them
- How clean and quiet the hospital was
- How well caregivers explained the steps patients
and families need to take to care for themselves outside of the
hospital (i.e., discharge instructions)
The survey also asks patients to give an overall
satisfaction rating to their hospital stay.