The
National Committee for Quality Assurance (NCQA) has
just released a set of ten emergency medicine quality measures for public
comment. The ED quality measures were developed by
Mathematica Policy Research,
NCQA
and the
AMA Physician Consortium. They are part of a
series of physician specialty quality measures developed for different
specialties and will ultimately be submitted to CMS for consideration as part of
the CMS voluntary reporting system.
The ED quality measures are not final yet. The deadline for public comment is
Friday, September 29, 2006.
Most of the measures are recycled AMI
and CAP guidelines, plus the Syncope Guideline initially developed by
ACEP's
Section on Quality Improvement and Patient Safety.
If adopted, they will likely form the basis for emergency department pay for
performance (P4P) standards from
Medicare
(CMS).
The new guidelines are as follows:
5 MI Guidelines
1. EKG within 5 min for all pts >30y/o w/ non-traumatic chest
pain
2. Lytics w/in 20 min after EKG performed (only if lytics are
given)
3. Call to Cardiologist (interventionalist) w/in 10 min after EKG
performed (only if PCI is performed)
4. ASA administered w/in 24 hours (documented)
5. Beta blockers administered w/in 24 hours (documented)
4 CAP Guidelines
1. VS documented (and reviewed) for CAP pts >18 y/o
2. Pulse Ox for CAP pts >18 y/o
3. Mental Status documented for CAP pts >18 y/o
4. Appropriate antibiotic for CAP pts >18 y/o
1 Syncope Guideline
1. EKG for all pts >60 y/o w/ syncope
The new emergency department guidelines are important because they represent the
first national quality "standards" for emergency care and set specific time
limits, evaluation, treatment and documentation requirements for certain classes
of patients. CMS plans to base emergency department reimbursement upon easily
identifiable standards such as these - and this will most likely be public
information in the future.
Link to the full report (22 page pdf)
Link to the NCQA page (Worksheet and Comments)
EM Quality Measures 
