“IMM” is short for global immunization and means that influenza and pneumococcal vaccine administration will be tracked on all hospital patients, not just those with pneumonia, who meet the age and high-risk criteria. Win’s word: You read that correctly. All inpatients require these vaccinations if they meet the criteria.
“Accountability measures” became part of The Joint Commission’s accreditation process Jan. 1. According to the commission’s website, they refer to a subset of core measures resulting in “the greatest positive impact on patient outcomes when hospitals demonstrate improvement on them.” Each accountability measure must meet these four criteria:
RESEARCH: There is strong evidence that compliance with this process of care improves outcomes.
PROXIMITY: The process being measured is “close” to the outcome (i.e. relatively few steps between the process and outcome).
ACCURACY: The measure accurately reflects that the process actually has been provided. Win’s word: In = “aspirin on arrival” and “ACE/ARB for LVSD.” Out = “smoking cessation counseling.” For smoking cessation, who knows if this was actually provided or the box was simply checked?
ADVERSE EFFECTS: The measure minimizes adverse effects. Win’s word: The “initial antibiotic timing” measure probably reduced diagnostic accuracy of pneumonia. See ya.
The other core measures will remain in their current form for now. Going forward, the IQR program provides hospitalists new opportunities to shine. These went into effect Jan. 1:
- Admit decision time to ED departure for admitted patients;
- Median time from ED arrival to ED departure for admitted patients; and
- Catheter-associated UTI rates.
As with all the measures, working in teams will be essential to success in these new measures. So go out there and hit a few more home runs (or at least a base hit or two). The season is well underway.
Dr. Whitcomb is medical director of healthcare quality at Baystate Medical Center in Springfield, Mass. He is co-founder of SHM and an expert in quality improvement and hospitalist practice management. Write to him at [email protected].