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- Core measures are national standards of care and treatment processes for common conditions.
- These processes are proven to reduce complications and lead to better patient outcomes.
- Core measure compliance shows how often a hospital provides each recommended treatment for certain medical conditions.
What is this measure?
Core measures are national standardized processes and best practices to improve patient care. These processes are designed to provide the right care at the right time for common conditions such as stroke or childhood asthma.
Specific steps for each condition vary, but examples include providing preventative medication to patients at risk for developing blood clots or determining rehabilitation needs for a stroke patient.
U.S. hospitals must report their compliance with these core measures to The Joint Commission, a health care accreditation organization, the Centers for Medicare and Medicaid Services and other agencies.
Examples of Core Measures+
One of the core measure sets includes eight steps in caring for a stroke patient.
- VTE prophylaxis – stroke patients received treatment to keep blood clots from forming anywhere in the body within two days of arriving at the hospital.
- Discharged on Antithrombotic Therapy – stroke patients received prescription before discharge for a medication known to prevent blood clots.
- Discharged on statin – stroke patients needing medication to lower cholesterol received prescription before discharge.
- Anticoagulation Therapy for Atrial Fibrillation – stroke patients with an abnormal heartbeat received blood-thinning medication.
- Thrombolytic therapy – stroke patients received medication to break up a blood clot within three hours after symptoms began.
- Antithrombotic Therapy by Day Two – stroke patients received medication known to prevent complications within two days of arriving at the hospital.
- Stroke education – stroke patients received education about stroke treatment and prevention.
- Assessed for Rehabilitation – health care team determined if stroke patients would need rehabilitation after leaving the hospital.
Why is it important?
The core measure processes are proven standards of care that reduce complications and lead to better patient outcomes. Patients and families can use core measure performance to objectively compare hospitals locally or nationally. The higher percentage compliance means the hospital is following the best steps to care for a patient’s particular condition.
The Joint Commission and the Centers for Medicare and Medicaid Services periodically redefine the core measures based on the latest evidence and nationwide hospital performance. The Joint Commission tracks compliance with core measures and each year recognizes the top performing hospitals for key quality metrics.
What is Johns Hopkins Medicine doing to continue to improve?
In 2011 Johns Hopkins Medicine developed a plan to become a national leader in core measures with a goal of reaching 96 percent compliance.
Collaborating Across Hospitals
Ensuring that patients always receive the core measure recommended treatments requires a well-coordinated effort throughout hospital departments.
Peers from across Johns Hopkins Medicine hospitals developed 40 core measure work groups, each focused on improving a specific set of core measures. These teams involved partnerships between quality improvement staff, nurse and physician leads, faculty members, IT staff and others to identify barriers to improvement and develop solutions.
The core measure work groups allowed hospitals to share best practices and lessons learned and improve internal processes to increase core measure compliance. Johns Hopkins Medicine also established a reporting system to track core measure compliance on each unit.
Michael Brinkman, R.N., M.S.N.
Quality Specialist, Sibley Memorial Hospital
“I love problem-solving, so I am always trying to make our hospital’s processes better to provide the safest care for our patients. Specifically, I focus on patients who stay overnight at the hospital and are at high risk for sepsis, a potentially life-threatening condition, as well as patients who visit the hospital for colonoscopies, a routine outpatient procedure.
Every two weeks, a multidisciplinary group meets to identify barriers to our hospital following the recommended best practices and to discuss opportunities for how we can improve. This group includes quality improvement staff members, doctors, nurses and our IT colleagues. We discuss possible interventions, including staff member and provider education.
The most important element to reducing or correcting any potential mistakes is prompt and constant communication with our physicians and clinical documentation colleagues. Swift feedback helps us to immediately concentrate on areas that need fixing and helps us demonstrate our compliance with best practices.
My favorite part of this job is to discover ongoing issues, work with the physicians and staff members to develop interventions to correct potential problems, and ultimately, provide the best and safest possible care to all of our patients.”
How can patients and families support safety?
Patients and families should become familiar with the core measures and talk to their health care team if they have any questions or concerns. You can also ask your health care provider how you can prepare for surgery or other procedures to reduce your risk of complications.
Be sure you clearly understand how to manage your health as you prepare to leave the hospital, such as any new prescription medications you may need.