QI Options

Advanced Directives (AD)

AIM Statement: By December 31, 2020, physicians in this QI effort will raise total number of patients aged 65-100 with AD from baseline to 50%.
Measure Numerator: Number of patients aged 55-65 who were introduced to ACP by physician 
Measure Denominator: Number of patients aged 55-65
Process or Operational:  Process
Tools: State of Ohio Advance Directives: Health Care Power of Attorney Living Will Declaration
Research: Comparing Approaches to Advance Care Planning for Patients with Advanced Illness
Articles: Implementing Advance Directives in Office Practice
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Measure Numerator: Number of chronically ill patients aged 55-100 who were introduced to ACP by physician
Measure Denominator: Number of chronically ill patients 55-100
Process or Operational:  Process
Tools: POLST: An improvement over traditional advance directives
Research: Learning the Experience - Tier I
Articles: Advance care planning and advance directives
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Measure Numerator: Patients who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.
Measure Denominator: Number of chronically ill patients 65 and older
Process or Operational:  Process
Tools: PREPARE is a step-by-step program with video stories to help you

BP in Control

AIM Statement:  By December 31, 2020, physicians in this QI effort will raise the percent of patients aged 18–85 years of age who had a diagnosis of hypertension and who’s blood pressure was adequately controlled by 10% from baseline.
Measure Numerator: The number of patients in the denominator whose most recent BP is adequately controlled during the measurement year. For a patient’s BP to be controlled, both the systolic and diastolic BP must be <140/90 (adequate control). To determine if a patient’s BP is adequately controlled, the representative BP must be identified.
Measure Denominator: Patients 18 to 85 years of age by the end of the measurement year who had at least one outpatient encounter with a diagnosis of hypertension (HTN) during the first six months of the measurement year.
Process or Operational: Outcome
QI Tools: American Heart Association’s Target BP Program - https://targetbp.org/blood-pressure-improvement-program/    |   Steps to Accurately Measure Blood Pressure   |   Treatment Algorithm
Research: Scientific statement on blood pressure measurement in people https://newsroom.heart.org/news/new-scientific-statement-on-blood-pressure-measurement-in-people

High blood pressure redefined for first time in 14 years: 130 is the new high - https://newsroom.heart.org/news/high-blood-pressure-redefined-for-first-time-in-14-years-130-is-the-new-high 
Articles: https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm 

Colorectal Cancer Screening

AIM Statement: By December 31, 2020, physicians in this QI effort will raise total number of patients aged 50–75 years of age who had appropriate screening for colorectal cancer from 2018 to target of 71%.
Measure Numerator: Number of patients aged 50–75 years of age who had appropriate screening for colorectal cancer
Measure Denominator: Total number of patients aged 50–75 years of age
Process or Operational:  Process
Tools: 70x2020 Colorectal Cancer Screening Initiative        Colorectal Cancer Screening Module        PREPARE is a step-by-step program with video stories to help you
Research: A Resident-Led QI Initiative to Improve Colorectal Cancer Screening Rates in the Center of Excellence for Primary Care Clinics
Articles:  Collaborative colorectal cancer screening: a successful quality improvement initiative       Family Physicians Must Demystify Colorectal Cancer Screening

Diabetes A1C

AIM Statement: By December 31, 2020, physicians in this QI effort will raise the total number of patients aged 18-75 years of age with diabetes (type 1 and type 2) whose most recent HbA1c level during the measurement year was greater than 9.0% (poor control) or was missing a result, or if an HbA1c test was not done during the measurement year from 2018 baseline to a target of 91%
Measure Numerator: Patients aged 18-75 years of age with diabetes (type 1 and type 2) whose most recent HbA1c level during the measurement year was greater than 9.0% (poor control) or was missing a result, or if an HbA1c test was not done
Measure Denominator: Total number patients aged 18-75 years with diabetes
Process or Operational:  Outcome
Tools: Using Personalized Risk/Benefit Profiles in SDM for Diabetes Prevention
Research: Diabetes Results That Can Make a Difference
Articles:

Influenza

AIM Statement: By December 31, 2020, the phsicians in this QI effort will increase influenza vaccination rates by 20% from baseline.
Measure Numerator:  of flu shots given
Measure Denominator: # of eligible flu shots to give
Process or Operational:  Process
Tools: Determine your practice’s current vaccination rates
Research: 
Articles: Effective and equitable influenza vaccine coverage in older and vulnerable adults: The need for evidence-based innovation and transformation     Flu Vaccination Rates in Clinics Drop as Day Progresses, but Computerized Nudges Help Give Them a Boost, Penn Study Finds

Maternal Depression

AIM Statement: Improve screening rates by 10% from baseline
Measure Numerator: # of Screenings Completed
Measure Denominator: # of patients seen who were eligible for screenings
Process or Operational: Process
QI Tools: Toolkit for pediatrics for postpartum depression screenings https://www.mcpapformoms.org/Docs/MCPAP%20for%20Moms%20Primer%203-14-18.pdf 

Toolkit for adult providers for postpartum depression screenings https://www.mcpapformoms.org/Toolkits/Toolkit.aspxhttps://www.mcpapformoms.org/Toolkits/Toolkit.aspx 

Key clinical considerations when assessing the mental health of pregnant/postpartum women https://www.mcpapformoms.org/Docs/Key%20Clinical%20Considerations%207-21-17.pdf 

Research: Postpartum depression screening in pediatric visits https://www.mcpapformoms.org/Docs/Pediatric%20Screening%20Algorithm%203-14-18.pdf  

Other: Edinburgh Postnatal Depression Scale (EPDS)   |   Patient Health Questionnaire - 9 (PHQ-9)

Tobacco Screening and Cessation

AIM Statement: By December 31, 2020, physicians involved in this QI effort, the percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months will reach 91%.
Measure Numerator: Total number of patients who screen positive for tobacco use
Measure Denominator: Total number of patients 18 years and older
Process or Operational: Process
QI Tools: Improving Tobacco Use Screening and Smoking Cessation in a Primary Care Practice
Research: Medical Assistance with Smoking and Tobacco Cessation: Findings from a 2014- 2015 Nationwide Survey of Adult Medicaid Beneficiaries
Articles: Tobacco Screening Multicomponent Quality Improvement Network Program: Beyond Education
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AIM Statement: By December 31, 2020, physicians involved in this QI effort, who have screened for tobacco use one or more times within 24 months who were refferd for tocabbo cessation intervention services will reach 91%
Measure Numerator: Number of positive tobacco screened patients who were referred to the pathways Community HUB for tobacco cessation services
Measure Denominator: Total number of patients who screen positive for tobacco use
Process or Operational: Process
QI Tools:Quality Improvement Project to Improve Screening for Tobacco Use in Adolescent Inpatients at a Children's Hospital Improving Tobacco Use Screening and Smoking Cessation in a Primary Care Practice     Quality Improvement Tools
Research: 
Articles: