Suggested Implementation Process
✔ Review standards
✔ Complete the self- assessment
✔ Review Transition of Care Consensus Measures
✔ Review the Metric Alignment list to evaluate current quality measures that cross walk to the TOC
Standards
✔ Determine relevant process and/or outcome measures
✔ Convene care continuum representatives (Ambulatory, ED, home health, skilled nursing
community/social agencies)
✔ Identify care transition opportunities
✔ Engage key organizational leaders
✔ Develop plan
✔ Reassess
Quality Metrics
All settings must assure that meaningful process, outcome and patient experience metrics are used to evaluate and continuously improve performance.
Structure
- Apply standards to support seamless transitions across all settings
- Standardize practice to guide transitions
- Align with regulations across care settings
- Maximize technology/interoperability
Process
- Assess organizational care transitions, identify gaps
- Benchmark performance across ACMA membership
- Partner with PCP, patient, family, community, social organizations
- Educate and identify enterprise care management opportunities
- Leverage bi-directional communication
Outcomes
- Patient engagement
- Improve patient experience
- Decrease readmission / ED utilization
- Medication safety
- Physician satisfaction
- Advance care planning improvements
Measurement of Care
There are over 2500 quality measures associated with care transitions, often practice specific (acute care, payer, ambulatory, skilled nursing facility, home health, hospice and other sites of services) which contributes to a silo approach to care transitions.
Aligned measurement is essential to meaningful assessment of gaps and opportunities for efficient care coordination. The consensus measures presented within this document are intended to guide evaluation efforts of the effectiveness of the implementation of the ACMA TOC Standards.
Overall Measures
2500 quality measures which may impact care transitions
Quality Program:
AHRQ, CMS,NQF, NCQA,
HEDIS, CAHPS, OASIS, HIS
Essential Measures
95 essential care transition measures
3 Key Quality Programs:
CMS, CAHPS, HEDIS
Consensus Measures
9 Consensus Measures
4 Process measures:
HEDIS Care Transition Measures
5 outcome measures:
Patient safety
Patient experience
Utilization
Cost
Readmission reduction measures selected from Key Quality Programs