Chief Complaint–Based Performance Measures: A New Focus for Acute Care Quality Measurement - 07/04/15
, Jesse M. Pines, MD, MBA b, Heather L. Farley, MD c, Michael P. Phelan, MD d, Christopher Beach, MD e, Jeremiah D. Schuur, MD, MHA f, Arjun K. Venkatesh, MD, MBA gAbstract |
Performance measures are increasingly important to guide meaningful quality improvement efforts and value-based reimbursement. Populations included in most current hospital performance measures are defined by recorded diagnoses using International Classification of Diseases, Ninth Revision codes in administrative claims data. Although the diagnosis-centric approach allows the assessment of disease-specific quality, it fails to measure one of the primary functions of emergency department (ED) care, which involves diagnosing, risk stratifying, and treating patients’ potentially life-threatening conditions according to symptoms (ie, chief complaints). In this article, we propose chief complaint–based quality measures as a means to enhance the evaluation of quality and value in emergency care. We discuss the potential benefits of chief complaint–based measures, describe opportunities to mitigate challenges, propose an example measure set, and present several recommendations to advance this paradigm in ED-based performance measurement.
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| Supervising editor: Donald M. Yealy, MD |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist and provided the following details: Dr. Griffey is supported by an institutional KM1 Comparative Effectiveness Award number KM1CA156708 through the National Cancer Institute at the National Institutes of Health (NIH) and grants UL1 RR024992, KL2 RR024994, and TL1 RR024995 through the Clinical and Translational Science Award program of the National Center for Research Resources and the National Center for Advancing Translational Sciences at the NIH, and by the Emergency Medicine Foundation/Emergency Medicine Patient Safety Foundation Patient Safety Fellowship. This work was supported by a Section Grant to the Quality Improvement and Patient Safety Section from the American College of Emergency Physicians. |
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| A podcast for this article is available at www.annemergmed.com. |
Vol 65 - N° 4
P. 387-395 - avril 2015 Retour au numéro
Article précédent
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- Arjun K. Venkatesh, Kate Goodrich
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