PQA Subcommittee of the Patient Safety Cluster Group - PowerPoint PPT Presentation

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PQA Subcommittee of the Patient Safety Cluster Group

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Charge: To identify a list or sub-set of lists that are already developed for ... and 3 pharmacists whom each have excellent background in area of geriatrics ... – PowerPoint PPT presentation

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Title: PQA Subcommittee of the Patient Safety Cluster Group


1
PQA Subcommittee of the Patient Safety Cluster
Group
  • Brad Tice, PharmD
  • Subcommittee Chair

2
PQA Subcommittee of the Patient Safety Cluster
Group
  • Charge To identify a list or sub-set of lists
    that are already developed for use within the PQA
    patient safety measures.
  • Key point The intent was to use a list already
    developed, not for the PQA to develop and
    maintain its own list.

3
Example of Measure for list application
Definitions Target medication Medication that
appears on the list of potentially inappropriate
medications for use in the population, age 65
years and older.
4
Background
  • Methods
  • Subcommittee of Patient Safety Cluster Group
    formed
  • Identify lists already in existence/use
  • Through committee
  • Through request for input from PQA membership
  • Establish criteria and review lists

5
Lists Identified
  • Beers list
  • Zhan criteria
  • NCQAs Use of High Risk Medications List

6
Review Criteria
  • Development methods
  • Current Use
  • Update/Maintenance
  • Completeness

7
Note Rankings are for descriptive purposes only
and do not represent actual or specific rankings
of committee
8
NCQA- High Risk MedicationsDevelopment
  • Field-test with Health Plans
  • Captured data on all drugs on Beers and Zhan
    lists
  • Examined prevalence according to Beer or Zhan
    classification
  • Goal
  • Identify prevalence of high risk medications
    prescribed
  • Reduce the list so that targeted quality
    improvement is possible

9
NCQA- High Risk MedicationsDevelopment
  • Technical Expert Panel
  • Reviewed field test results
  • Identified Zhan categories never appropriate
    and rarely appropriate as basis for list
  • For Beers high severity drugs not classified by
    Zhan conducted modified-Delphi process for
    inclusion in measure

10
NCQA- High Risk MedicationsDevelopment
  • Released for Public Comment
  • Approval by Geriatric Measurement Advisory Panel
    (GMAP)
  • Approval by Committee on Performance Measurement
    (CPM) for inclusion into HEDIS 2006

11
NCQA- High Risk MedicationsMaintenance
  • Analysis of first year data
  • Review with TEP and GMAP
  • Approval by CPM for public-reporting in HEDIS
    2007
  • Continually receive comments through NCQAs
    Policy Clarification Support
  • Review new medications every year and make
    updates
  • Decisions for updates based upon Beers and
    Zhans classifications

12
NCQA- Use of High Risk MedicationsMaintenance
  • Re-evaluate measure every three years
  • Review data
  • Solicit public comment
  • Updates as necessary
  • Review with TEP and GMAP
  • Approval by CPM

13
Recommendation
  • The PQA Patient Safety Cluster Group Subcommittee
    recommends using the NCQA Use of High Risk
    Medications List (formerly known as the Drugs to
    be Avoided in the Elderly List) as the list to
    be used when developing technical specifications.
  • Rationale
  • List is developed by a Technical Expert Panel
    consisting of 3 physicians and 3 pharmacists whom
    each have excellent background in area of
    geriatrics
  • List is maintained and therefore will be updated,
    also allowing for open comment period
  • List is a part of HEDIS measures and therefore
    will be used across health care settings,
    allowing for equivalent comparisons

14
PQA Action Needed
  • Questions?
  • Call for Endorsement of the NCQA List to be used
    as technical specifications are developed on
    patient safety.
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