Quality Measures for Heart Attack

Aspirin at Arrival for Heart Attack: 
Higher scores are better

Why is this important?
Aspirin has been shown to prevent clotting and to restore blood flow to the heart.  Taking an aspirin as soon as symptoms of a heart attack begin may reduce the severity of the attack.  Patients should take aspirin within 24 hours of arrival at the hospital.

Aspirin at Discharge for Heart Attack:
Higher scores are better

Why is this important?
Aspirin has been shown to prevent blockage of blood flow to the heart.  To help prevent further heart problems, aspirin should be prescribed to eligible patients when they leave the hospital.

Beta Blockers at Arrival for Heart Attack: 
Higher scores are better

Why is this important?
Beta blockers are medicines used to lower blood pressure, treat chest pain (angina), heart failure and to help prevent a heart attack.  Beta blocker medications have been shown to help patients recover from a heart attack, and should be given within 24 hours of arrival to help prevent further heart problems.

Beta Blockers at Discharge for Heart Attack: 
Higher scores are better

Why is this important?
Beta blockers relieve the stress on the heart by slowing the heart rate and reducing the force that the heart muscle uses to contract.  Beta blocker medications are recommended at discharge to help prevent future heart attacks. 

ACE Inhibitor or ARB for LVSD for Heart Attack: 
Higher scores are better

Why is this important?
Angiotensin converting enzyme  inhibitors (ACEI) and angiotensin receptor blockers (ARBs) are medicines used to treat heart attacks, high blood pressure, and heart failure.  ACEI and ARBs are frequently prescribed for a condition called "left ventricular systolic dysfunction" which is a decreased function of the left part of the heart.  ACE inhibitor and ARB should be prescribed at discharge to help prevent further heart problems. 

Smoking Cessation Counseling for Heart Attack:
Higher scores are better

Why is this important?
Smoking increases the risk of disease that can damage the heart, resulting in heart attack, heart failure or stroke, and is also linked to lung disease, cancer and premature death.  Smoking cessation counseling is recommended as part of a comprehensive treatment and prevention strategy in reducing future risk for heart attacks and heart failure.

Quality Measures for Heart Failure

Assessment of Left Ventricular Function for Heart Failure:
Higher scores are better

Why is this important?
Assessment of left ventricular function (LVF), the heart's ability to pump blood effectively, is a standard of care for heart failure patients.   Health care providers will use this test, along with other tests to determine if the left side of the heart is pumping properly.

ACE Inhibitor or ARB at Discharge for Heart Failure Patients: 
Higher scores are better

Why is this important?
Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are types of medications that have been shown to help lower blood pressure and prevent future heart problems.  Eligible patients should have ACE inhibitors or ARBs prescribed when they leave the hospital.

Smoking Cessation Counseling for Heart Failure:
Higher scores are better

Why is this important?
Smoking increases the risk of disease that can result in damage to the heart resulting in heart attack, heart failure or stroke.  Smoking is also linked to lung disease, cancer and premature death.  Smoking cessation counseling and information to help quit smoking is recommended as part of a comprehensive treatment and prevention strategy in reducing future risk for heart attacks and heart failure.

Discharge Instructions for Heart Failure:
Higher scores are better

Why is this important?
Heart failure is a chronic condition with symptoms including shortness of breath, dizziness, and fatigue. Before leaving the hospital you and/or your caregivers should be provided with information to help manage the symptoms when you are at home. The information should include: activity level (what you can and can’t do), diet (what you should, and shouldn’t eat or drink), medications, follow-up appointments, monitoring of daily weights, and what to do if symptoms get worse.

Quality Measures for Pneumonia

Time to Treat for Pneumonia:
Higher scores are better

Why is this important? 
Antibiotics are used to treat adults with pneumonia caused by bacteria.  Early treatment with antibiotics can cure bacterial pneumonia and reduce the possibility of complications.  It is beneficial for patients admitted with pneumonia to receive their initial dose of antibiotic medications within six hours of the time they arrived at the hospital. 

Initial blood culture in the Emergency Department performed prior to first dose of antibiotic:
Higher scores are better

Why is this important? 
A blood culture is a test that can help your health care provider identify which bacteria may have caused pneumonia and assist in determining which antibiotic should be prescribed. A blood culture is not always needed, but for patients who are first seen in the hospital emergency department, it is important for the accuracy of the test that blood culture be conducted before any antibiotics are started.

Initial Selection of Appropriate Antibiotic:
Higher scores are better

Why is this important? 
Pneumonia is a lung infection that is usually caused by bacteria or a virus. Bacterial pneumonia is treated with antibiotics. Different antibiotics are selected based on factors including drug resistant types of bacteria, patient allergies, and the setting where the patient is treated.

Oxygenation Assessment for Pneumonia: 
Higher scores are better

Why is this important? 
Pneumonia can lower the oxygen in blood because the air spaces in the lungs fill with fluid, and oxygen does not get into the lungs.  When treating patients with pneumonia, it is important to know how much oxygen is in their blood to determine if oxygen therapy is needed. 

Use of Pneumococcal Vaccine:
Higher scores are better

Why is this important?  
The pneumococcal vaccine may help prevent or lower the risk of complications of pneumonia cause by bacteria.  It may also help prevent future infections.  Certain groups of patients including those hospitalized with pneumonia, should receive immunization for pneumococcal pneumonia.

Use of the Influenza Vaccine:
Higher scores are better

Why is this important? 
Flu shots reduce the risk of influenza, a serious and sometimes deadly lung infection that can spread quickly in a community or facility.  Patients with pneumonia, particularly those who are age 50 or older, should get a flu shot during flu season to protect them from another lung infection and to prevent the spread of influenza. Since a flu shot is effective for just one flu season, the period of time used to calculate this rate is the flu season from October through March), in contrast to other measures, which are generally collected throughout the year. 

Smoking Cessation Counseling for Pneumonia:
Higher scores are better

Why is this important?
Smoking increases the risks of developing pneumonia, as well as chronic lung diseases including emphysema and bronchitis. Smoking is also linked to cancer, heart attack, heart failure, stroke and premature death.  Smoking cessation counseling and information to help quit smoking is recommended as part of a comprehensive treatment and prevention strategy in reducing future risk for getting pneumonia.

Quality Measures for Surgical Care Improvement Project

Prophylactic Antibiotic Received within 1 Hour Prior to Surgery:
Higher scores are better

Why is this important?
Antibiotics are medicines to prevent and treat infections. Research shows that surgery patients who get antibiotics within the hour before their operation are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, is not as effective. This shows how often hospitals make sure surgery patients get antibiotics at the right time.

Prophylactic Antibiotic Selection:
Higher scores are better

Why is this important?
A goal of prophylaxis with antibiotics is to use an agent that is safe, inexpensive, and has a spectrum of action that covers most of the probable intraoperative contaminants for the operation. Patients undergoing the following procedures are included: Colon surgery, hip arthroplasty, knee arthroplasty, hysterectomy and vascular surgery.

Prophylactic Antibiotic Discontinued within 24 Hours After Surgery:
Higher scores are better

Why is this important?
While infection after surgery can be reduced by giving patients preventative antibiotics, taking these antibiotics for more than 24 hours after routine surgery is usually not necessary and can increase the risk of side effects including stomach aches, diarrhea, and antibiotic resistance. There are exceptions, so talk to your doctor if you have questions about how long you should take antibiotics after surgery.

Recommended VTE Prophylaxis Ordered:
Higher scores are better

Why is this important?
Surgery patients who receive appropriate venous thromboembolism (VTE) prophylaxis within 24 hours prior to surgery to 24 hours after surgery are at lower risk for deep vein thrombosis and pulmonary embolism. Without preventive treatment, or prophylaxis, deep vein thrombosis occurs in 25% and pulmonary embolism (clots in arteries supplying blood to the lungs) occurs in 7% of all major surgical procedures.

Recommended VTE Prophylaxis Received:
Higher scores are better

Why is this important?
Surgery patients who receive appropriate venous thromboembolism prophylaxis within 24 hours prior to surgery to 24 hours after surgery are at lower risk for deep vein thrombosis and pulmonary embolism. Despite the well-established efficacy and safety of preventive measures, studies show that prophylaxis is often underused or inappropriately used.