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What are clinical quality measures used for?

What are clinical quality measures used for?

What are clinical quality measures used for? Identify five clinical quality measures used by CMS. Describe the general structure of the five clinical quality measures you identified and explain how they are reported. Provide an example of how each of the five clinical quality measures you identified are designed to improve the quality of care.

What are clinical quality measures used for?

Clinical quality measures are crucial to the success of any healthcare organization or facility. It is imperative for these organization to carry out clinical quality measures from time to time because they do provide useful clues in identification of the organization’s areas of strength and weakness. Additionally, these measures can provide a springboard upon which healthcare organizations can use to drive improvement of care services. Moreover, this will health in determination of whether there are disparities in terms of care delivery and outcomes (D’Amore et al., 2018). The clinical quality measures taken will show whether a certain care practice or service is being utilized appropriately or not and how best to harness the available resources and ensure maximum patient satisfaction and quality care services.

There are five core quality measures used by the Center for Medicaid and Medicare services (CMS) which include; patient safety, population health, coordination of care, clinical processes and patient and the family engagement during the care process.  For nurses, providing high-quality patient care has always been a top priority. With the current government emphasis on reporting, improving care, and reimbursement, nurses and their institutions are more accountable than ever for delivering and documenting excellent patient care. Through a collaborative effort of collegial interdisciplinary care delivery, a more responsive documentation system, real-time quality assurance, and ongoing education, our institution improved compliance reports for the CMS quality indicators (D’Amore et al., 2018).

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The five clinical quality measures are reported based on the data collected through the use of electronic clinical quality measurement(eCQMs) tools. The measurement criteria are based on three quality areas, that is; evidence-based medicine, code sets and measure logic. States have the flexibility to determine the method of reporting eCQMs and the submission period under the Medicaid Promoting Interoperability Program, subject to prior approval by CMS. Under the Medicaid Promoting Interoperability Program, states also have the flexibility to determine the specifications that may be used to electronically report eCQMs (Centers for Medicare & Medicaid Services, 2018).

What are clinical quality measures used for?

Quality improvement efforts must be measured to show whether (i) they lead to a change in the primary end point in the desired direction, (ii) contribute to unintended consequences in different parts of the system, and (iii) necessitate additional efforts to bring a process back into acceptable ranges. The rationale for measuring quality improvement is the belief that good performance reflects good practice and that comparing performance across providers and organizations will encourage better performance. There has been a surge in measuring and reporting the performance of health care systems and processes in recent years (Backhouse & Ogunlayi, 2020).

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Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice. BMJ, m865. https://doi.org/10.1136/bmj.m865

Centers for Medicare & Medicaid Services. (2018). Clinical Quality Measures Basics | CMS. Cms.gov. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ClinicalQualityMeasures

D’Amore, J., Li, C., McCrary, L., Niloff, J., Sittig, D., McCoy, A., & Wright, A. (2018). Using Clinical Data Standards to Measure Quality: A New Approach. Applied Clinical Informatics, 09(02), 422–431. https://doi.org/10.1055/s-0038-1656548

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