Joint Commission lists ORYX indicators

5 focus areas announced

Here is a listing of the core ORYX performance measures from the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations in the five focus areas:

1. Acute myocardial infarction (AMI).

— Smoking cessation advice/counseling: AMI patients with a history of smoking who are given smoking cessation advice or counseling during hospitalization.

— Aspirin at arrival: AMI patients who are given aspirin within 24 hours of arrival or within 24 hours prior to arrival at the hospital.

— Reperfusion therapy — time from arrival to initiation; timely reperfusion (opening blocked arteries) of eligible AMI patients; time from arrival to initiation of thrombolysis medication administration or primary percutaneous transluminal coronary angioplasty procedure.

— Aspirin at discharge: AMI patients who are prescribed aspirin at discharge from the hospital.

— Beta blocker at arrival: AMI patients who receive beta blocker medication within the first 24 hours of arrival to the hospital.

— Left-ventricular ejection fraction (LVEF).

— Less than 40% prescribed angiotensin-converting enzyme inhibitor (ACEI) at discharge: AMI patients with low left-ventricular ejection fraction (index of how well the heart functions) who are prescribed an ACEI medication at discharge from the hospital.

— Beta blocker at discharge: AMI patients who are ideal candidates for beta blocker medication and who are given a prescription for beta blockers at discharge.

— Intrahospital mortality: Patients with a primary diagnosis of AMI who die during hospitalization.

2. Heart failure.

— Patients with atrial fibrillation (irregular heartbeat) prescribed warfarin at discharge: Heart failure patients with atrial fibrillation who are given a prescription for oral anticoagulation therapy (warfarin) at discharge from the hospital.

— Diet/weight/medication management instructions at discharge: Heart failure patients who receive patient education (as documented on their written discharge instructions) regarding all of the following: all discharge medications, weight monitoring, diet, activity level, follow-up appointment, and steps to take if symptoms worsen.

— Assessment of left-ventricular function: Heart failure patients not admitted on ACEIs or angiotensin receptor blocking agent medications who have LVEF evaluated before or during admission.

— LVEF.

— Less than 40% prescribed ACEI at discharge: Patients with low LVEF who are prescribed an ACEI medication at discharge.

— Smoking cessation advice/counseling: Heart failure patients with a history of smoking who are given smoking cessation advice or counseling during hospitalization.

3. Community-acquired pneumonia.

— Pneumonia screen or pneumococcal vaccination: Patients 65 or older who are screened for or given pneumococcal vaccination during hospitalization.

— Smoking cessation advice/counseling: Pneumonia patients with a history of smoking who are given smoking cessation advice or counseling during hospitalization, or pediatric caregivers who are given advice or counseling about effects of secondhand smoke.

— Oxygenation assessment: Patients who receive oxygenation assessment (to determine amount of oxygen in blood) within 24 hours of hospital arrival.

— Blood cultures: Of patients who have blood cultures collected, those who had them drawn prior to first dose of antibiotic administration in the hospital.

— Antibiotic timing: time (in hours) from initial presentation at hospital to first dose of antibiotics.

— Empiric antibiotic regimen nonintensive care unit: For pneumonia patients not admitted to an ICU, the antibiotic given is consistent with current con sensus guidelines [such as the New York City-based American Thoracic Society, the Alexandria, VA-based Infectious Disease Society of America, and the Atlanta-based Centers for Disease Control and Prevention (CDC)].

— Empiric antibiotic regimen ICU: For pneumonia patients admitted to an ICU, the antibiotic given is consistent with current consensus guidelines (such as the American Thoracic Society, Infectious Disease Society of America, and the CDC).

4. Surgical procedures and complications.

— Surgical site infection within 30 days (for selected surgical procedures).

— Timing of prophylactic administration of antibiotic: when patients were given prophylactic (preventive) intravenous antibiotic administration for selected surgical procedures.

5. Pregnancy and related conditions.

— Vaginal birth after cesarean rate.

— Third- or fourth-degree laceration.

— Neonatal mortality: Infants who die within 28 days of birth.