Quality Improvement Support: Diagnosis and …...Numerator and Denominator Definitions Numerator: Number of patients with blood pressure measurement greater than 160/100 mmHg. Denominator:
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The Aims and Measures section is intended to provide guideline users with a menu of measures for multiple purposes, which may include the following:
• othermeasuresfromlocalandnationalorganizationsaimedatmeasuringpopulation health and improvement of care delivery.
This section provides resources, strategies and measurement for use in closing thegapbetweencurrentclinicalpracticeandtherecommendationssetforthintheguideline.
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults
1
Institute for Clinical Systems Improvement
www.icsi.org2
Aims and MeasuresNote: a multifactorial intervention targeting hyperglycemia and cardiovascular risk factors in individuals withdiabetes ismost effective. Both individualmeasures of diabetes care, aswell as comprehensivemeasuresofperformanceonbroadersetsofmeasures,arerecommended.Arandomizedcontrolledtrialhas shown a 50% reduction in major cardiovascular events through a multifactorial intervention targeting hyperglycemia,hypertension,dyslipidemia,microalbuminuria,aspirinandACEinhibitoruseinindividualswithmicroalbuminuria(Gaede, 2003).
GoalsforA1c,low-densitylipoproteinandotherdiabetesmeasuresshouldbepersonalized,andlowergoalsforA1candlow-densitylipoproteinthanthoseincludedhereinthepriorityaimsandmeasuresmaybeclini-callyjustifiedinsomeadultswithT2DM.However,effortstoachieveA1cbelow7%mayincreaseriskofmortality,weightgain,hypoglycemiaandotheradverseeffectsinmanypatientswithT2DM.Therefore,the aims and measures listed here are selected carefully in the interests of patient safety.
GoalsforA1c,low-densitylipoproteinandotherdiabetesmeasuresshouldbepersonalized,andlowergoalsforA1candlow-densitylipoproteinthanthoseincludedhereinthepriorityaimsandmeasuresmaybeclini-callyjustifiedinsomeadultswithT2DM.However,effortstoachieveA1cbelow7%mayincreaseriskofmortality,weightgain,hypoglycemiaandotheradverseeffectsinmanypatientswithT2DM.Therefore,the aims and measures listed here are selected carefully in the interests of patient safety.
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Method/Source of Data CollectionDatashouldbecollectedfromEMRforallpatientvisitsinthepast12months.
NotesThis is a process measure, and improvement is noted as a decrease in the rate. The purpose of this measure istodecreasethepercentageofadultpatientsages18-75withT2DMwithpoorlycontrolledglucoseandcardiovascularriskfactors(clinicalstrategiesthat targethigh-riskpopulationsmaybemoreviablewithlimited resources).
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Method/Source of Data CollectionDatashouldbecollectedfromEMRforallpatientvisitsinthepast12months.
NotesThis is a process measure, and improvement is noted as a decrease in the rate. The purpose of this measure istodecreasethepercentageofadultpatientsages18-75withT2DMwithpoorlycontrolledglucoseandcardiovascularriskfactors(clinicalstrategiesthat targethigh-riskpopulationsmaybemoreviablewithlimited resources).
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Method/Source of Data CollectionDatashouldbecollectedfromEMRforallpatientvisitsinthepast12months.
NotesThis is a process measure, and improvement is noted as a decrease in the rate. The purpose of this measure istodecreasethepercentageofadultpatientsages18-75withT2DMwithpoorlycontrolledglucoseandcardiovascularriskfactors(clinicalstrategiesthat targethigh-riskpopulationsmaybemoreviablewithlimited resources).
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Method/Source of Data CollectionDatashouldbecollectedfromEMRforallpatientvisitsinthepast12months.
NotesThis is a process measure, and improvement is noted as a decrease in the rate. The purpose of this measure istodecreasethepercentageofadultpatientsages18-75withT2DMwithpoorlycontrolledglucoseandcardiovascularriskfactors(clinicalstrategiesthat targethigh-riskpopulationsmaybemoreviablewithlimited resources).
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Method/Source of Data CollectionDatashouldbecollectedfromEMRforallpatientvisitsinthepast12months.
NotesThis is a process measure, and improvement is noted as a decrease in the rate. The purpose of this measure istodecreasethepercentageofadultpatientsages18-75withT2DMwithpoorlycontrolledglucoseandcardiovascularriskfactors(clinicalstrategiesthat targethigh-riskpopulationsmaybemoreviablewithlimited resources).
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Method/Source of Data CollectionDatashouldbecollectedfromEMRforallpatientvisitsinthepast12months.
NotesThis is a process measure, and improvement is noted as a decrease in the rate. The purpose of this measure istodecreasethepercentageofadultpatientsages18-75withT2DMwithpoorlycontrolledglucoseandcardiovascularriskfactors(clinicalstrategiesthat targethigh-riskpopulationsmaybemoreviablewithlimited resources).
Diagnosis and Management of Type 2 Diabetes Mellitus in Adults Aims and Measures Sixteenth Edition/July 2014
Institute for Clinical Systems Improvement
www.icsi.org12
Measurement #3a
Measurement DescriptionPercentageofnewlydiagnosedpatientswhoareadvisedaboutlifestylemodificationandnutritiontherapywithin one year of diagnosis.
Population DefinitionPatientsages18-75yearsoldwithT2DM.
Data of Interest#ofpatientswhoareadvisedaboutlifestylemodificationandnutritiontherapywithinoneyearof
diagnosis
#ofpatientsages18-75yearsoldwithT2DM
Numerator and Denominator DefinitionsNumerator: Numberofpatientswhoareadvisedaboutlifestylemodificationandnutritiontherapywithin