Quality improvement in neurology: AAN Parkinson disease quality measures: report of the Quality Measurement and Reporting Subcommittee of the American Academy of Neurology

E M Cheng, S Tonn, R Swain-Eng, S A Factor, W J Weiner, C T Bever Jr, American Academy of Neurology Parkinson Disease Measure Development Panel, E M Cheng, S Tonn, R Swain-Eng, S A Factor, W J Weiner, C T Bever Jr, American Academy of Neurology Parkinson Disease Measure Development Panel

Abstract

Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this.

Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs.

Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors.

Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes.

Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures.

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References

    1. Lee TH. Eulogy for a quality measure. N Engl J Med 2007;357:1175–1177.
    1. Harman JS, Scholle SH, Ng JH, et al. Association of Health Plans' Healthcare Effectiveness Data and Information Set (HEDIS) performance with outcomes of enrollees with diabetes. Med Care 2010;48:217–223.
    1. Chassin MR, Loeb JM, Schmaltz SP, Wachter RM. Accountability measures: using measurement to promote quality improvement. N Engl J Med 2010;363:68–688.
    1. Roland M, Campbell S, Bailey N, Whalley D, Sibbald B. Financial incentives to improve the quality of primary care in the U.K.: predicting the consequences of change. Prim Health Care Res Dev 2006;7:18–26.
    1. Centers for Medicare and Medicaid Services. Overview: Physician Quality Reporting Initiative. Available at: Accessed May 3, 2010.
    1. Doran T, Fullwood C, Gravelle H, et al. Pay-for-performance programs in family practices in the United Kingdom. N Engl J Med 2006;355:375–384.
    1. Bridges to Excellence: About Us. Available at: . Accessed May 3, 2010.
    1. Endsley S, Kirkegaard M, Baker G, Murko AC. Getting rewards for your results: pay-for-performance programs. March 2004. Available at: . Accessed May 3, 2010.
    1. Faulkner LR, Tivnan PW, Johnston MV, et al. Invited article: The ABPN maintenance of certification program for neurologists: past, present, and future. Neurology 2008;71:599–604.
    1. Horowitz SD. Invited article: Maintenance of certification: the next phase in assessing and improving physician performance. Neurology 2008;71:605–609.
    1. Donabedian A, Wheeler JR, Wyszewianski L. Quality, cost, and health: an integrative model. Med Care 1982;20:975–992.
    1. American Academy of Neurology. Strategic plan 2003, practice and patient care. Available at: . Accessed May 24, 2010.
    1. Bever CT, Dubinsky R, Tonn S, Swain-Eng R, for the Quality Measures and Reporting Subcommittee. Quality Measures Process Manual: 2008 Edition. St. Paul, MN: American Academy of Neurology; Approved by the AAN Board of Directors December 18, 2008.
    1. Center for Health Policy Studies, Harvard School of Public Health, Center for Quality of Care Research and Education. Understanding and choosing clinical performance measures for quality improvement: development of typology: final report. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 1995.
    1. Lawthers AW, Palmer H. In search of a few good performance measures. In: Seltzer J, Nash DB, eds. Models for Measuring Quality in Managed Care: Analysis and Impact (Medical Outcomes & Practice Guidelines Library II). New York: Faulkner & Gray's Healthcare Information Center; 1997:121–150.
    1. American Academy of Neurology/American College of Radiology/Physician Consortium for Performance Improvement/National Committee for Quality Assurance. Stroke and Stroke Rehabilitation: Physician Performance Measure Set. September 2006. Updated February 2009. Available at: . Accessed May 3, 2010.
    1. Performance Measurement Coordinating Council. Desirable Attributes of Performance Measures: A Consensus Document from the AMA, JCAHO, and NCQA. 1999.
    1. Physician Consortium for Performance Improvement Position Statement: The evidence base required for measure development. Available at: . Accessed May 10, 2010.
    1. Miyasaki J, Martin W, Suchowersky O, Weiner W, Lang A. Practice parameter: initiation of treatment for Parkinson's disease: an evidence-based review: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2002;58:11–17.
    1. Suchowersky O, Reich S, Perlmutter J, Zesiewicz T, Gronseth G, Weiner W. Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006;66:968–975.
    1. Pahwa R, Factor S, Lyons K, et al. Practice parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006;66:983–995.
    1. Miyasaki J, Shannon K, Voon V, et al. Practice parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006;66:996–1002.
    1. Suchowersky O, Gronseth G, Perlmutter J, Reich S, Zesiewicz T, Weiner W. Practice parameter: neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006;66:976–982.
    1. National Collaborating Centre for Primary Care. National Collaborating Centre for Chronic Conditions. Parkinson's Disease: National Clinical Guideline for Management in Primary and Secondary Care. London: Royal College of Physicians; 2006.
    1. Horstink M, Tolosa E, Bonuccelli U, et al, European Federation of Neurological Societies, Movement Disorder Society-European Section. Review of the therapeutic management of Parkinson's disease: report of a joint task force of the European Federation of Neurological Societies, the Movement Disorder Society-European Section: part I: early (uncomplicated) Parkinson's disease. Eur J Neurol 2006;13:1170–1185.
    1. Horstink M, Tolosa E, Bonuccelli U, et al, European Federation of Neurological Societies, Movement Disorder Society-European Section. Review of the therapeutic management of Parkinson's disease: report of a joint task force of the EFNS, the MDS-ES: part II: late (complicated) Parkinson's disease. Eur J Neurol 2006;13:1186–1202.
    1. National Collaborating Centre for Chronic Conditions. Parkinson's Disease: National Clinical Guideline for Management in Primary and Secondary Care. London: Royal College of Physicians; 2006.
    1. Horstink M, Tolosa E, Bonuccelli U, et al. Review of the therapeutic management of Parkinson's disease: report of a joint task force of the European Federation of Neurological Societies (EFNS) and the Movement Disorder Society-European Section (MDS-ES): part II: late (complicated) Parkinson's disease. Eur J Neurol 2006;13:1186–1202.
    1. Horstink M, Tolosa E, Bonuccelli U, et al. Review of the therapeutic management of Parkinson's disease: report of a joint task force of the European Federation of Neurological Societies and the Movement Disorder Society-European Section: part I: early (uncomplicated) Parkinson's disease. Eur J Neurol 2006;13:1170–1185.
    1. Goetz CG, Koller WC, Poewe W, et al. Management of Parkinson's disease: an evidence-based review. Mov Disord 2002;17(suppl 4):S1–166.
    1. Goetz CG, Poewe W, Rascol O, Sampaio C. Evidence-based medical review update: pharmacological and surgical treatments of Parkinson's disease: 2001 to 2004. Mov Disord 2005;20:523–539.
    1. Cheng EM, Siderowf A, Swarztrauber K, et al. Development of quality of care indicators for Parkinson's disease. Mov Disord 2004;19:136–150.
    1. Donabedian A. The quality of care: how can it be assessed? JAMA 1988;260:1743–1748.
    1. Institute of Medicine. Crossing the Quality Chasm: A New Health Care System for the 21st Century. Washington, DC: National Academy Press; 2001.
    1. National Priorities Partnership. National Priorities and Goals. November 2008. Available at: . Accessed August 3, 2010.
    1. Zesiewicz TA, Sullivan KL, Arnulf I, et al. Practice parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74:924–931.
    1. Chrischilles EA, Rubbenstein LM, Voelker MD, Wallace RB, Rodnitzky RL. Linking clinical variables to health-related quality of life in Parkinson disease. Parkinsonism Related Disord 2002;8:199–209.
    1. Kmetik K. PCPI: what you should know about Consortium performance measures. J Fam Pract 2007;56(suppl A): 8A–12A.
    1. Physician Consortium for Performance Improvement. Principles for Performance Measurement in Health Care: A Consensus Statement from the American Medical Association, The Joint Commission on Accreditation of Healthcare Organizations and the National Committee for Quality Assurance. Chicago, IL: American Medical Association; 2000.
    1. Eagle KA, Garson AJ, Beller GA, Sennett C. Closing the gap between science and practice: the need for professional leadership. Health Aff 2003;2:196–201.
    1. Ferris TG, Vogell C, Marder J, Sennett CS, Campbell EG. Physician specialty societies and the development of physician performance measures. Health Aff 2007;26:1712–1719.
    1. Congressional legislation H.R. 3590. Patient protection and affordable care act. Public law no. 111–148; March 23, 2010.
    1. American Board of Psychiatry and Neurology. ABPN Maintenance of certification requirement: 26 July 2009. Available at: . Accessed May 4, 2010.

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