Are the Core Measures A Report Card On Quality?
Unfortunately, the scores on the core measures can create misleading impressions when used as a hospital rating tool instead of an improvement tool, particularly for small hospitals. For example, if a small hospital received an 83% on the Heart Failure indicator does that mean that 17% of patients got substandard care or did patients at a hospital which scored 90% get better care? The first score could indicate low quality care, but not necessarily. For example, a small hospital may have only 6 patients in a quarter who qualify for the measurement. Say for one of those six, the physician or the nurse provides an aspect of care but fails to document properly. In the data collection process, that counts as a “miss.” So, only 5 of the 6 patients are counted as appropriate and the hospital gets a score of 83%. Data findings are shared with staff and can be utilized as an improvement tool by determining an area within the medical record to provide a prompt for the appropriate documentation
Related Questions
- If I perform multiple procedures on the same day that are eligible for reporting of performance measures, do I need to report the quality codes (CPT II or g-codes) for each procedure or just once?
- What will happen to physicians if they are not EHR-active and using the technology to report clinical quality measures in time? What will happen to hospitals?
- My child’s report card/conference form indicates excellent work. Why isn’t my child in the core group?
