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NCQA Emergency Medicine Quality Measures

ED News: NCQA Releases Emergency Medicine Quality Measures


The National Committee for Quality Assurance (NCQA) has just released a set of ten emergency medicine quality measures for public comment. The ED quality measures were developed by Mathematica Policy Research, NCQA and the AMA Physician Consortium. They are part of a series of physician specialty quality measures developed for different specialties and will ultimately be submitted to CMS for consideration as part of the CMS voluntary reporting system.  

The ED quality measures are not final yet. The deadline for public comment is Friday, September 29, 2006.  

Most of the measures are recycled AMI and CAP guidelines, plus the Syncope Guideline initially developed by ACEP's Section on Quality Improvement and Patient Safety.  If adopted, they will likely form the basis for emergency department pay for performance (P4P) standards from Medicare (CMS).

The new guidelines are as follows:

5 MI Guidelines
        1. EKG within 5 min for all pts >30y/o w/ non-traumatic chest pain
        2. Lytics w/in 20 min after EKG performed (only if lytics are given)
        3. Call to Cardiologist (interventionalist) w/in 10 min after EKG performed (only if PCI is performed)
        4. ASA administered w/in 24 hours (documented)
        5. Beta blockers administered w/in 24 hours (documented)

4 CAP Guidelines
        1. VS documented (and reviewed) for CAP pts >18 y/o
        2. Pulse Ox  for CAP pts >18 y/o
        3. Mental Status documented for CAP pts >18 y/o
        4. Appropriate antibiotic for CAP pts >18 y/o

1 Syncope Guideline
        1. EKG for all pts >60 y/o w/ syncope

The new emergency department guidelines are important because they represent the first national quality "standards" for emergency care and set specific time limits, evaluation, treatment and documentation requirements for certain classes of patients. CMS plans to base emergency department reimbursement upon easily identifiable standards such as these - and this will most likely be public information in the future.


Link to the full report (22 page pdf)

Link to the NCQA page (Worksheet and Comments)



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