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Welcome back, everyone.
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Measuring performance is central
to improving the quality of health care.
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Performance measurements
conveys the message of importance.
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That is what is important is measured,
while what is not measured
is considered less important by many.
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Measures of health care quality
that make use
of readily available hospital
inpatient administrative data
are known as quality indicators.
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Quality indicators are standardized
evidence-based measures
of health care quality
that can be used
with readily available data
to measure and track
clinical performance and outcomes.
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The quality indicators developed
and maintained
by the Agency for Healthcare
Research and Quality
are one response to the need
for multidimensional,
accessible quality measures
that can be used to gauge
performance in health care.
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The QIs are evidence-based
and can be used to identify
variations in the quality of care
provided on both an inpatient
and outpatient basis.
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These measures are currently organized
into four modules:
the prevention of quality indicators,
inpatient quality indicators,
patient safety indicators,
and pediatric quality indicators.
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Prevention quality indicators identify
ambulatory care sensitive conditions
defined as conditions
for which good outpatient care
can potentially prevent
the need for hospitalization
or for which early intervention
can prevent complications
or more severe disease.
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PQI examples include:
diabetes long-term complication
admission rate,
chronic obstructive pulmonary disease
admission rates,
hypertension admission rates,
congestive heart failure
admission rates,
low birth weight rate,
and dehydration admission rate.
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The PQIs help answer questions
such as:
Does the admission rate
for diabetes complications in my community
suggest a problem in the provision
of appropriate outpatient care
to this population?
Also, how does the admission rate
for congestive heart failure vary over time
and from one region
of the country to another?
Inpatient quality indicators
provide information
about the quality of medical care
delivered in a hospital
and represents the state of the art
in measuring the quality of hospital care
using inpatient administrative data.
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The IQIs include measures
in the areas of inpatient mortality,
utilization of procedures
for which there are questions
of overuse, underuse, or misuse.
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Volume of procedures
for which there is evidence
that a higher volume is associated
with lower mortality.
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There are four different levels
of inpatient quality indicators
and they are
provider-level volume indicators,
mortality indicators
for inpatient procedures,
mortality indicators
for impatient conditions,
and utilization indicators.
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Patient safety indicators
provides information
on potentially avoidable safety events
that represent opportunities
for improvement
in the delivery of care.
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More specifically, they focus
on potential in-hospital complications
and adverse events following surgeries,
procedures, and childbirth.
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Patient safety indicators can be used
to help hospitals assess
the incidence of adverse events
and in-hospital complications,
identify issues that might need
further study.
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Some PSI examples include:
a pressure ulcer rate,
post-operative sepsis rate,
birth trauma rate-injury to neonates,
postoperative respiratory failure rate.
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A pediatric quality indicator
reflects the quality of care
for children younger than 17 years of age
and neonates inside hospitals,
and identify potentially
avoidable hospitalization among children.
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PDIs examples include:
pediatric heart surgery mortality,
postoperative respiratory failure,
postoperative sepsis,
asthma admission rates,
and gastroenteritis admission rates.
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Current uses for QI include:
quality improvement,
Public Reporting
and Paper Performance,
research.
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Quality indicators are
an important part of the equation
when it comes to providing
the best care possible.
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But measuring these indicators
is not simply good science,
it's an ethical imperative.
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Nursing foundational principles
and guidelines state
that as a profession,
nursing has a responsibility
to measure, evaluate,
and improve the quality
of nursing practice.
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So when thinking of everything
that we've discussed today,
I'd like for you to consider this question.
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What are the four AHRQ quality indicators?
They are prevention quality indicators,
inpatient quality indicators,
patient safety indicators,
and finally, pediatric quality indicators.
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I hope you've enjoyed today's video
on Quality Indicators.
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Thanks so much for watching.