In October 2003, Qualis Health, under a contract with Centers for Medicare & Medicaid Services (CMS), began a study focused on identification of preliminary Quality Performance Measures (QPMs) reflecting emergency room care provided to Medicare beneficiaries. This work was a continuation of work done the previous year (
Phase I), during which the uses of Emergency Department (ED) administrative data were explored to find out if such data could be used to identify ED care measures, as well as looking for any other uses the data might have.
During the second year (Phase Two), medical records abstraction was used to further explore areas for ED Quality/Performance measures that could improve care provided to Medicare beneficiaries.
Factors considered in the selection of QPMs included intrinsic clinical validity, evidence-basis (when possible), cost-effectiveness of measurement, and potential or identified clinical impact. QPMs also needed to align with other national priorities for clinical performance measurement and reporting, such as the CMS hospital measures and relevant JCAHO core measure elements.
Work for Phase Two of this study included:
- A national call for measures
- Engagement of a stakeholder group interested in emergency department care, and
- Utilization of a Technical Expert Panel (TEP).
The TEP for Phase Two was selected based on individual skills and experience in emergency department clinical care, quality improvement, development of quality measures, administration, or use of CMS administrative data. The TEP is working with data analysts and technical writers at Qualis Health to develop standard definitions for the population; identify potential indicators for further development from currently available data; help refine the information gathered; and finalize a report to CMS.
- The first TEP conference for Phase Two was held in October 2003. The meeting focused on possible clinical domains for QPMs, with descriptions of specific process or outcomes of ED care; population definitions and exclusions; and element descriptions.
- During the Spring 2004 TEP conference, the TEP reviewed the results of feasibility testing, further clarified clinical and operational issues, and proposed further directions for this work.
- A Final Report summarizing the work was presented at the Fall 2004 TEP conference, during which areas were selected for further measures development. This work has continued through the Summer of 2005.
Agendas, daily summaries, and copies of presentations made at these conferences are available on the Tools page of this Website.
