Medicare Core Measures 

The Medicare Core Measures were established in 2002 by the Centers for Medicare & Medicaid Services. The core measures -- which were carefully researched and have been scientifically shown to improve outcomes of patient care -- were created for patients to ensure that they receive the best health care available. The core measures include steps we take to prevent or treat acute myocardial infarction, heart failure and pneumonia as well as follow the guidelines of the surgical care improvement project.

Acute Myocardial Infarction

An acute myocardial infarction (AMI) is a heart attack, and more than one million Americans have heart attacks every year.

Because heart attacks can be fatal, recognition of the symptoms of a heart attack and the speed of the initial response are extremely important, particularly in those who may have already had a cardiac arrest, which is a sudden stopping of the heart ‘s pumping action.

To maximize the likelihood of survival after the onset of AMI symptoms, patients need to receive reperfusion therapy in the form of percutaneous coronary intervention (PCI), also called coronary or balloon angioplasty, within 90 minutes. Coronary or balloon angioplasty is the inflation of a balloon within the coronary artery to crush the plaque -- the sticky deposits that build up in the inner lining of an artery that can cause stroke or heart attack-- into the walls of the artery.

Heart attack patients also need specific items in the care they receive after a heart attack, according to the best current research, which Exempla medical staffs provide.

At Exempla, we provide the specific care that the latest research has shown is most effective in treating heart attack patients. This "protocol" for treating heart attack patients includes:

• Aspirin at arrival
• Beta blocker at arrival
• Primary PCI received within 90 minutes of hospital arrival
• An angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB) -- both of which lower blood pressure by blocking the formation of angiotensin II in the kidney, leading to relaxation of the arteries -- prescribed for left ventricular systolic dysfunction, a heart condition in which the left ventricle does not contract properly and cannot pump blood properly from the heart to the rest of the body
• Adult smoking-cessation advice/counseling
• Beta blocker prescribed at discharge
• Aspirin prescribed at discharge.

How are we doing?

Exempla's goal is to have our rate of compliance with all the steps in the AMI "protocol" match, every month, the rate of the top 10% of hospitals in the United States. The top 10% have a compliance rate of 100%.

Heart Failure

Heart failure is a weakening of the heart's pumping power. With heart failure, the body does not get enough oxygen and nutrients to meet its needs. The heart tries to pump more blood, but the muscle walls become weaker over time. Symptoms of heart failure may include shortness of breath from fluid in the lungs, swelling (such as in legs, ankles or abdomen), dizziness, fatigue, weakness, cold or clammy skin and a rapid or irregular heartbeat.

At Exempla, we provide the specific care that the latest research indicates is most effective for treating heart failure. The heart failure protocol includes:

• Appropriate discharge instructions
• Evaluation of left ventricular systolic function
• ACEI or ARB medication for left ventricular systolic dysfunction
• Smoking-cessation education.

How are we doing?

Pneumonia

What is pneumonia?

Pneumonia is an infection in one or both lungs caused by bacteria. Every year approximately 3 million people contract pneumonia in the United States, and more than 500,000 of them are admitted to hospitals.

Pneumonia can be a deadly disease. Every year 5% of those with pneumonia die, making it the sixth leading cause of death in the United States.

At Exempla, our care of patients is based on the current, best medical research on the most effective treatment of pneumonia. Our pneumonia care protocol includes:

• Timely antibiotic administration (within 4 hours of arrival at the hospital)
• Appropriate antibiotic selection (for both ICU and non-ICU patients)
• Pneumococcal vaccination
• Smoking-cessation education
• Oxygenation assessment, which helps speed effective treatment
• Blood culture collection in the emergency department prior to antibiotic administration, which also helps speed effective treatment.

How are we doing?

Exempla's goal is to have our rate of compliance with all the steps in the pneumonia protocol match, every month, the rate of the top 10% of hospitals in the United States. The top 10% have a compliance rate of 99.3%. 

Surgical Care Improvement Project  

What is the Surgical Care Improvement Project (SCIP)

The Surgical Care Improvement Project (SCIP) is a national partnership of health care organizations seeking to improve surgical care by significantly reducing surgical complications. SCIP was formed by the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) in 2003.

How does surgery affect overall hospital care?

Patients undergoing surgery are at risk for developing complications that can create additional health risks, lengthen their stay in the hospital or even be fatal. These complications include infections at the surgical site, blood clots and heart attacks.

At Exempla, our care of surgery patients follows recommendations based on the best current research, and endorsed by SCIP, to minimize post-operative risks. Our surgical protocol includes:

• Providing a prophylactic antibiotic within 1 hour prior to surgical incision
• Providing a prophylactic antibiotic selection for surgical patients consistent with each type of surgical procedure
• Discontinuing the prophylactic antibiotic within 24 hours after the end of surgery because prolonged use of antibiotics increases the risk of Clostridium difficile infection -- a bacterium that causes diarrhea and more serious intestinal conditions such as colitis -- and the development of pathogens -microorganisms such as bacteria, viruses or parasites that can cause disease -- resistant to antibiotics
• Controlling postoperative serum glucose in cardiac surgery patients because high blood sugar weakens the immune system and increases the risk of infection
• Clipping the hair of surgery patients rather than shaving because skin abrasions increase the risk of infection
• Maintaining immediate postoperative normothermia (normal temperature) in colorectal surgery patients because increased temperatures pose a greater risk of infection, prolonged healing of wounds and longer hospital stays.

How are we doing?

Exempla's goal is to have our rate of compliance with all the steps in the SCIP protocol match, every month, the rate of the top 10% of hospitals in the United States. The top 10% have a compliance rate of 99.3%

 

	Goal	July 2011 YTD Performance
Measure	Exempla Hospitals	ELMC	ESJH	EGSMC
Surgical Care Improvement Project (SCIP)  Appropriate Care Score	91.2%	91.9%	92.0%	89.1%

Contact Us

If you have any questions now about these measures and our performance, please contact: Exempla Healthcare's Care Team.