Key Aspects of Care for Three Clinical Advantage Projects
Key Aspects of Care for Three Clinical Advantage Projects
Stroke
Key aspects of care
• stroke patient managed by a multi-disciplinary approach
• access to tPA option provided within three hours of stroke onset
• aspirin within 48 hours of onset
• use of sublingual nifedipine avoided during hospitalization
• DVT prophylaxis administered
• NPO until swallowing assessed (more than gag reflex)
• urinary catheter removed as soon as possible
• aspirin or other antiplatelet/anti-coagulant agent prescribed upon discharge
• patient with atrial fibrillation prescribed anticoagulant upon discharge
• patient referred for rehabilitation services shortly after admission
Acute Myocardial Infarction
Key aspects of care
• percentage of eligible reperfusion patients who underwent thrombolysis and/or PTCA
• time to initial reperfusion
• early administration of aspirin
• early administration of beta-blockers
• ACE inhibitor for low LVEF
• aspirin at discharge
• smoking cessation counseling provided
Breast Cancer
Key aspects of care
• proportion of women between the ages of 40 and 69 having a mammogram within two years
• time of abnormal mammography to diagnosis is less than or equal to one week
• proportion of mammography-only abnormalities diagnoses by needle biopsy technique
• proportion of patients whose breast cancer was detected at Stage 0 or 1
• proportion of Stage 0, 1, and 2 patients who undergo breast-conserving surgery with adjuvant radiation therapy
• proportion of patients with positive node disease who are treated with adjuvant chemotherapy or tamoxifen
• proportion of patients satisfied with time-liness, information, communication, and care decision-making process
Source: VHA Clinical Advantage, Irving, TX.
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