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About the Measures

The initial set of quality measures selected for use in CheckPoint are a subset of common performance measures developed by the Centers of Medicare and Medicaid Services (CMS), the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and endorsed by the National Quality Forum. Scientific evidence indicates that they represent the best standard of care for the treatment of some of the most common and costly conditions resulting in hospitalization. Hospitals continuously strive to give 100% of their patients the recommended standard of care.

The data is collected as follows:

Medical Services -- Hospitals gather the medical services data from individual patient charts, in compliance with HIPAA patient privacy regulations, and report data to the national Centers for Medicare and Medicaid Services (CMS).

The medical services data will be updated every three months.

It is very difficult to measure the quality of health care. One method is to measure how often health care providers make use of treatments that have been shown to be most effective. The 14 medical services measures in CheckPoint help consumers understand how effective the care is that they receive in a hospital compared to care that research indicates will lead to the best outcome. There are six measures for heart attack, four measures for congestive heart failure and four measures for pneumonia.

Heart Attack Measures
1.
 Aspirin at arrival - Percent of heart attack patients that receive an aspirin within 24 hours before or after arriving at the hospital
2.
 Aspirin at discharge - Percent of heart attack patients that are prescribed an aspirin when they are discharged from the hospital
3.
 Beta-blocker at arrival - Percent of heart attack patients that receive a beta blocker medication within 24 hours of arrival at the hospital
4.
 Beta-blocker at discharge - Percent of heart attack patients that are prescribed a beta-blocker medication when they are discharged from the hospital
5.
 ACE Inhibitor for Left Ventricular Systolic Dysfunction (LVSD) - Percent of heart attack patients with low heart function that are prescribed an ACE inhiitor medication when they are discharged from the hospital
6.
 Smoking Cessation Counseling - Percent of heart attack patients with a current or recent history of smoking cigarettes, who are given smoking cessation counseling during their hospital stay.
Congestive Heart Failure
7.
 Left Ventricular Function (LVF) assessment - Percent of heart failure patients that are given a test to assess the function of their heart before, during or soon after discharge from the hospital
8.
 ACE Inhibitor for Left Ventricular Systolic Dysfunction (LVSD) - Percent of congestive heart failure patients with low heart function that are prescribed an ACE inhibitor medication when they are discharged from the hospital
9.
 Smoking Cessation Counseling - Percent of heart attack patients with a current or recent history of smoking cigarettes, who are given smoking cessation counseling during their hospital stay.
10.
 Discharge Instructions - Percent of heart failure patients discharged to home with written instructions to the patient or caregiver that addresses all of the following: activity level, diet, discharge medications, follow-up appointment, weight monitoring, and what to do if symptoms worsen.
Pneumonia
11.
 First antibiotic within 4 hours - Percent of patients admitted to the hospital with pneumonia that receive their first dose of antibiotic within 4 hours of arrival.
12.
 Oxygen assessment - Percent of patients admitted to the hospital with pneumonia that have their oxygen level evaluated within 24 hours prior to or after arrival at the hospital
13.
 Pneumococcal screening and/or vaccination - Percent of patients 65 years and older admitted to the hospital with pneumonia that are asked if they had received a pneumococcal vaccination, and if they had not, received the vaccination prior to discharge from the hospital
14.
 Smoking Cessation Counseling - Percent of patients admitted to the hospital with pneumonia that have a current or recent history of smoking cigarettes, who are given smoking cessation counseling during their hospital stay.
No data collected at this time or no cases met criteria?
 Not all hospitals collect and report data for all of the measures reported in CheckPoint. There are several reasons for this.
  • Hospitals treat different types of patients based on the needs of their communities. A hospital may not provide direct care to the type of patients that are reported on by one or more of the measures in CheckPoint. If a patient requires care that is not provided by the hospital where they are currently receiving care, that hospital will arrange a transfer to an appropriate facility.
  • Hospitals provide many types of care. Each hospital has a quality improvement plan which determines which types of patients they will monitor and focus their improvement efforts on. If a hospital determines that they will not monitor their care in an area where CheckPoint has measures, this hospital will not have any data to report to CheckPoint for that type of care.
  • In order for a patient's information to be included in a CheckPoint measure, that patient must meet certain criteria. The criteria are required to increase the chance that the information reported for each hospital is the same. If a patient's information does not meet this criteria, that case is removed from the measure. On occasion, this will eliminate all cases from the report for an individual hospital even though they provide that type of care.
Data collected, but not enough cases to be representative of care provided in this reporting period?
 The medical services measures include cases that are collected over four calendar quarters. Each quarter, the reports are updated to include more current quarters. In order to meet the CheckPoint criteria for public reporting, a hospital must have at least 25 cases in the four quarters that are combined to make up that report. The 25 case minimum requirement increases the chance that the rate reported accurately represents the hospital's patient population for that measure. If a hospital has submitted cases, but does not meet the 25 cases minimum requirement, a + sign appears for that measure. As hospitals add cases over time, more hospitals will meet the 25 case minimum requirement and will be able to care report their actual rates.