Systematic Evidence-Based Quality Measurement Life-Cycle Approach to Measure Retirement in CHIPRA

Dougherty, Denise; Mistry, Kamila B.; Lindly, Olivia J.; Desoto, Maushami; LLanos, Karen; Chesley, Francis

doi:10.1016/j.acap.2014.06.015

Cited by 7 publications

(3 citation statements)

References 10 publications

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“… Multiple Specific Outcomes Data-driven System cost-effectiveness [ 40 ] - Academic researchers -Health care organizations To elicit the health value of suboptimal treatment approaches. Multiple Specific Outcomes Expert panel Systematic evidence-based quality measurement [ 41 ] - Centers for Medicare and Medicaid Services (CMS) - Agency for Healthcare Research and Quality (AHRQ) To reexamine selected health care quality measures from a child core set (CCS) voluntarily reported on by a number of state Medicaid and Children’s Health Insurance Program (CHIP) programs over the 3 federal fiscal years in the US. Multiple Specific Process Data-driven Value framework for specialty drugs [ 42 ] Hospital Pharmacy & Therapeutics Committee To assess the value of specialty drugs in order to decide which ones to be funded within a hospital setting.…”

Section: Resultsmentioning

confidence: 99%

Assessing value in health care: using an interpretive classification system to understand existing practices based on a systematic review

Seixas

Dionne²,

Conte

et al. 2019

BMC Health Serv Res

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Background Implementing adequate strategies to assess the value of health services plays a central role in the effort to deal with the financial pressures faced by health care systems worldwide. This study aimed to understand which approaches to value assessment have been used in developed countries. Methods We conducted a rapid review and a gray literature search to identify value assessment frameworks. A two-stage screening process was utilized to identify existing approaches and cluster similar frameworks. In addition, we developed an interpretive classification system to make sense of existing approaches. Results One thousand one hundred seventy-six references were identified and 38 papers were selected for full-review. Among these 38 articles, 22 distinct approaches to assess value of health care interventions were identified and classified according to four points: 1) use of single or multiple considerations to base value estimates; 2) use of disease-specific or generic criteria; 3) reliance on process-based or outcomes-based consideration; and 4) type of input and evidence considered. Conclusions The contextual nature of value assessment in health care becomes evident with the diversity of existing approaches. Despite the predominance of cases relying on the Incremental cost-effectiveness ratio as the measure of value, this approach has not been sufficient to meet the needs of decision-makers. The use of multiple criteria has become more and more important, as well as the consideration of patient-reported measures. Considerations of costs are not always explicit and consistent. Electronic supplementary material The online version of this article (10.1186/s12913-019-4405-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Assessing value in health care: using an interpretive classification system to understand existing practices based on a systematic review

Seixas

Dionne²,

Conte

et al. 2019

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Strategies for measuring retirement include achievement of a ceiling effect or sustained performance at or above target. 29 In our program, we sought sustained performance at the target to judge retirement eligibility.…”

Section: Discussionmentioning

confidence: 99%

A Framework for Maintenance and Scaling of an Evidence-based Guideline Program

Seneski

Stack

2019

Pediatric Quality &Amp; Safety

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Introduction: Use of Evidence-based Guidelines (EBGs) has been shown to improve and standardize care. After implementation and maturation of a guideline program, next steps include incorporating new evidence, sustaining adherence, minimizing measurement burden and fostering scaling of the program. We propose a framework for maintenance and dissemination of an EBG program. Methods: Using a program of 28 EBGs developed for use in a pediatric emergency department (ED) in 2010, we developed: a framework for iterative review and revision, a strategy to measure ongoing use in practice and an approach for minimizing repeated measurement sufficient to evaluate outcomes. Also, we created a process to spread the EBG program to the hospital's Department of Pediatrics. Results: The framework for maintenance and spread of a program of EBGs resulted in an annual review of individual guidelines with 14 revisions warranted by new evidence, some leading to decreased medication utilization and hospitalization rates. We demonstrated adherence to key quality measures, and decreased the number of measures from 89 to 43, retiring 46 measures with stable peformance. We spread the process for program development to the hospital pediatric department resulting in 36 new EBGs. Conclusions: We developed a framework for maintenance and scale of a program of EBGs. Our key learning points were that regular incorporation of new evidence, assessment and feedback on performance and leadership with administrative support are necessary to maintain improvement. This framework may assure sustainability and inform other guideline programs. We offer processes to promote guideline dissemination within an academic hospital.

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“…30 To address these concerns, measures are sometimes retired once performance "tops off" (ie, when most providers are scoring near or at 100%), on the basis that the value in ongoing measurement will be limited. 31,32 For example, CMS has started retiring a number of heart failure and heart attack measures such as the prescribing of β-blockers at discharge for patients with a myocardial infarction. 33 Ongoing scrutiny and willingness to retire measures help guard against the problems created by accretion, but finding the "sweet spot" for the number and type of measures and ensuring an optimal set is in place at any given point in time remain ongoing challenges.…”

Section: Circulationmentioning

confidence: 99%