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Helsejanuar 07, 2022

Core quality measures compliance requires a better QI process

Now more than ever, hospital reputation and reimbursements are on the line.

Hospitals and health systems are driven to provide high-quality service, constantly seeking to improve patient care. Many organizations may have their own sets of care standards to steer them towards achieving their strategic goals. However, the performance measure sets developed and implemented by the Core Quality Measures Collaborative (CQMC) are the guiding principles used by providers and payers — and have a strong influence on consumer choice.

Quality improvement (QI) projects can propel ongoing upgrades in healthcare provision and strengthen core measures compliance, but only if they are launched, completed, and disseminated efficiently. QI projects with redundant or inapplicable recommendations are not worth the effort that teams invest.

Core performance measures support the value-based care initiative

The emergence of value-based care generated a formidable challenge: how can the quality of healthcare be accurately measured? In 2015, the Centers for Medicare & Medicaid Services (CMS) and America’s Health Insurance Providers (AHIP) formed the Core Quality Measures Collaborative housed by the National Quality Forum (NQF) to pick up the gauntlet. CQMC has gone on to develop fundamental performance measures to help reduce care variability and improve overall patient care in the US. Some 75 stakeholder organizations, from consumer groups to medical associations, health insurance providers to purchasers, create consensus-based core measures.

The CQMC identified specific goals for its core measures sets:

  • Promote evidence-based measurement that can be applied to QI
  • Support consumer decision-making
  • Increase value-based payment and purchasing
  • Reduce measure selection variability
  • Decrease provider’s collection burden and cost.

Core measures focus on designated clinical areas, supplying metrics to assess the delivery of healthcare in each of those areas. New sets have been created since the Collaborative began its work. Today, core measures are used to evaluate care in 10 high-priority clinical areas:

  • Accountable Care Organizations/Patient-Centered Medical Homes/Primary Care
  • Behavioral Health
  • Cardiology
  • Gastroenterology
  • HIV & Hepatitis C
  • Medical Oncology
  • Neurology
  • Obstetrics & Gynecology
  • Orthopaedics
  • Pediatrics.

The CQMC continues to add insights and best practices to help hospitals and health systems adhere to the core measures sets and is also considering other clinical areas that might gain from their own sets of quality measures.

Response to quality deficiencies often falls short

When healthcare facilities appraise their compliance with core quality measures, it’s not unusual to find room for improvement. Many hospitals have robust quality improvement programs, constantly reviewing care delivery from all angles to identify and fill gaps. QI projects are one of the tactics they employ, using existing evidence to begin a course correction process.

But how efficient are these quality improvement projects? Often, QI teams end up duplicating previous efforts and experiencing roadblocks to collaboration. There is no simple way for projects to be prioritized, for new people to join a team, or for team members to document and track the evolution of a project. The teams may have no standard workflow and no way to easily communicate or get feedback on a specific stage of the QI project.

Quality improvement projects require searches of top-quality current clinical literature from multiple sources to ensure that the best information will be applied to solving or easing the identified problem. But if searches take too long, become too disjointed, or aren’t revealing the most up-to-date knowledge on the problem, the project findings may be invalid or ineffective.

And what about senior management? Does the hospital C-suite have comprehensive oversight of all ongoing and historical QI projects, a way to quickly tell if a project isn’t on track? If executives do not have a handle on how quality improvement projects are progressing (or if they should be happening at all), imagine how much time and money is being wasted!

Organize, standardize, and accelerate quality improvement

When hospitals look at their compliance with core quality measures, they must also examine their process for maintaining that compliance. At a minimum, they need:

  • Real-time visibility into all projects at the executive and projects levels
  • Standardized, configurable templates for QI workflows
  • Collaboration capabilities within project templates
  • Integrated search and full-text retrieval
  • AI-driven literature appraisal
  • Automated evidence synthesis and project reporting.

Together, these capabilities can help hospitals transform their quality improvement process into a finely tuned engine that powers their compliance with core quality measures — and sets them apart from the competition.

Learn how Ovid Synthesis can support quality improvement process and maintain compliance.

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