PQRS

BACKGROUND: A recent study shows that a multifaceted strategy using an individualised intra-abdominal pressure titration strategy during colorectal laparoscopic surgery results in an acceptable workspace at low intra-abdominal pressure in most patients. The multifaceted strategy, focused on lower to individualised intra-abdominal pressures, includes prestretching the abdominal wall during initial insufflation, deep neuromuscular blockade, low tidal volume ventilation settings and a modified lithotomy position...

BACKGROUND: The prognostic significance of paced QRS complex morphology on surface ECG remains unclear. This study aimed to assess long-term outcomes associated with variations in the paced QRS complex. METHODS: Adult patients who underwent dual-chamber pacemaker implantation with 20% or more ventricular pacing and a 12-lead ECG showing a paced complex were included. The paced QRS was analyzed in leads I and aVL. Long-term clinical and echocardiographic outcomes were compared at 5 years...

OBJECTIVE: This proof-of-concept feasibility trial examined the potential of the Cognitive Orientation to daily Occupational Performance Approach (CO-OP) to augment deep brain stimulation (DBS) outcomes in childhood-onset hyperkinetic movement disorders (HMD) including dystonia and dyskinetic cerebral palsy. METHODS: This is a single case experimental design using multiple baseline as n-of-1 trial comprising 10 intervention sessions, with replications across participants (n = 10)...

PURPOSE: Radiologists have historically participated as individuals in CMS pay-for-performance programs, but little is known about how radiologists perform under increasingly available group participation. We aimed to assess radiologists' relative national performance on CMS quality metrics using group versus individual participation. METHODS: Radiologists' group- and individual-level 2016 performance on Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR) measures were obtained from the CMS national Physician Compare database and compared...

OBJECTIVE: The aim of the study was to determine the association of patient-reported experiences (PREs) and risk-adjusted surgical outcomes among group practices. BACKGROUND: The Centers for Medicare and Medicaid Services required large group practices to submit PREs data for successful participation in the Physician Quality Reporting System (PQRS) using the Consumer Assessment of Healthcare Providers and Systems for PQRS survey. Whether these PREs data correlate with perioperative outcomes remains ill defined...

BACKGROUND: Pacing from RV mid septum and outflow tract septum has been proposed as a more physiological site of pacing and narrower paced QRS complex duration. The paced QRS morphology and duration in different RV pacing sites is under continued discussion. Hence, this study was designed to address the correlation of pacing sites in right ventricle with paced QRS complex duration. METHODS: Two hundred fifty-two consecutive patients who underwent pacemaker implantation were enrolled...

The automated detection of arrhythmia in a Holter ECG signal is a challenging task due to its complex clinical content and data quantity. It is also challenging due to the fact that Holter ECG is usually affected by noise. Such noise may be the result of the regular activity of patients using the Holter ECG-partially unplugged electrodes, short-time disconnections due to movement, or disturbances caused by electric devices or infrastructure. Furthermore, regular patient activities such as movement also affect the ECG signals and, in connection with artificial noise, may render the ECG non-readable or may lead to misinterpretation of the ECG...

OBJECTIVE: We investigated the quality of randomized controlled trials (RCTs) that included direct comparisons of psychotherapy for adults with an eating disorder (ED). METHOD: Thirty-five direct comparison RCTs of psychotherapy for adults diagnosed with an ED were rated using the Randomized Controlled Trials Psychotherapy Quality Rating Scale (RCT-PQRS). RESULTS: The mean total RCT-PQRS score (mean = 28.26; SD = 7.04) was in line with those that were reported for RCTs of psychotherapy for depression and anxiety disorders...

BACKGROUND CONTEXT: As increasing numbers of elderly Americans undergo spinal surgery, it is important to identify which patients are at highest risk for poor cognitive and functional recovery. Frailty is a geriatric syndrome that has been closely linked to poor outcomes, and short-form screening may be a helpful tool for preoperative identification of at-risk patients. PURPOSE: This study aimed to conduct a pilot study on the usefulness of a short-form screening tool to identify elderly patients at increased risk for prolonged cognitive and functional recovery following elective spine surgery...

Background: Electronic health records (EHRs), despite their positive attributes, increase physician workload and decrease efficiency. The aim of this study was to evaluate the impact of scribes in the Inflammatory Bowel Disease Clinic on improvement of the physician-patient relationship, physician productivity, clinical efficiency, and achievement of some Physician Quality Reporting System (PQRS) metrics. Methods: We analyzed of pre- and postscribe data between fiscal years 2015 (FY15) and 2016 (FY16) using data from patients at the Inflammatory Bowel Clinic at the University of Florida...

BACKGROUND: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measure 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008 to 2012...

PURPOSE: The Medicare Access and CHIP Reauthorization Act (MACRA) Quality performance category is the successor to the Physician Quality and Reporting System (PQRS) program and now contributes to physicians' income adjustments based upon performance rates calculated for a minimum of six measures. We assess radiologists' frequency of reporting PQRS measures as a marker of preparedness for MACRA. METHODS: Medicare-participating radiologists were randomly searched through the Physician Compare website until identifying 1,000 radiologists who reported at least one PQRS measure...

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BACKGROUND: A holistic, intensive and interdisciplinary rehabilitation program for people with acquired brain injury (ABI) was developed at the Pitié-Salpêtrière Hospital, France (5 days/week for 7 weeks). This program, recently demonstrated effective, aimed to optimize the ability of people with ABI to perform activities and improve their participation by using individual and group interventions involving ecologically valid activities inside (e.g., in the gym and kitchen) and outside the hospital...

BACKGROUND: Measuring quality outcomes is an important prerequisite to improve quality of care. Rhinosinusitis represents a high value target to improve quality of care because it has a high prevalence of disease, large economic burden, and large practice variation. In this study we review the current state of quality measurement for management of both acute (ARS) and chronic rhinosinusitis (CRS). METHODS: The major national quality metric repositories and clearinghouses were queried...

PURPOSE: To report the current quality measures that are applicable to orthopaedic sports medicine physicians. METHODS: Six databases were searched with a customized search term to identify quality measures relevant to orthopaedic sports medicine surgeons: MEDLINE/PubMed, EMBASE, the National Quality Forum (NQF) Quality Positioning System (QPS), the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC), the Physician Quality Reporting System (PQRS) database, and the American Academy of Orthopaedic Surgeons (AAOS) website...

BACKGROUND: Cognitive Orientation to daily Occupational Performance (CO-OP) approach based on cognitive strategy in occupational therapy. OBJECTIVES: To investigate the effects of CO-OP approach on occupational performance in individuals with hemiparetic stroke. METHODS: This study was designed as a 5-week, randomized, single-blind. Forty-three participants who had a diagnosis of first stroke were enrolled in this study. The participants were randomly assigned to the experimental group (n = 20) or the control group (n = 23)...

253 Background: Clinically meaningful quality measures have been identified as a catalyst for healthcare improvement and better patient outcomes. Amidst rapidly changing quality reporting and re-imbursement schema, eligible providers struggle to choose a portfolio of measures across multiple registries that will demonstrate the value of their practice to consumers and payers. It is critical that a roadmap to quality improvement be evident to registry users. Utilizing the Model for Improvement developed by the Associates in Process Improvement and adapted to health care by the Institute for Healthcare Improvement, a framework to guide performance improvement was developed and incorporated into an oncology specific QCDR for PQRS reporting...

260 Background: For reporting purposes and to enable ongoing quality improvement, it is essential that metrics reflective of quality oncology care delivery are tracked and reviewed on an ongoing basis. Collection of performance data and incorporation into a usable dashboard can require significant IT resources, both in personnel time and direct costs. The Tisch Cancer Institute (TCI) identified a myriad of cancer quality metrics that required prioritization in order to best allocate limited IT resources and a standardized process to facilitate comparison across different disease groups...

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category...