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Davies SM, Geppert J, McClellan M, et al. Refinement of the HCUP Quality Indicators. Rockville (MD): Agency for Healthcare Research and Quality (US); 2001 May. (Technical Reviews, No. 4.)

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Refinement of the HCUP Quality Indicators.

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APPENDIX 4Data Collection Instruments

These data collection instruments were used in the preliminary and full abstraction phases of the Phase1 literature review: "Identifying indicators". Three forms are provided in the following order: 1.) Full article abstraction, 2.) Risk adjustment, and 3.) Initial screening. They provide a structured mechanism for data collection. However, currently most literature available does not provide the level of detail required by these forms. These forms may be useful for future projects once the health care quality literature expands to include more validation studies and detailed reports of potential indicators.

Abstractor's Initials:
Date Abstracted:

Indicator Data Collection Instrument
UCSF-Stanford EPC/AHCPR HCUP QI

Measure Header
Measure Set Name (e.g., HEDIS, DEMPAQ): 
Developer Subset Name 
Performance Measure Name: 
Measure Code: System assigned
Type of Measure: (structure/process/proxy-outcome/outcome) 
Year Published: 
Year Most Recently Updated: ("Update"= change in construction of measure) 
Developer
  Organization (ie. JCAHO, NCQA)
  Last Name, First Name
  Affiliation (University, Dept.)
  Address
  Phone
  Email
 
Contact Person (if different from Developer)
  Last Name, First Name
  Affiliation (University, Dept.)
  Address
  Phone
  Email
 
Technical Support Available: Image f3334_SQU.jpg YES Image f3334_SQU.jpg NO Image f3334_SQU.jpg Unclear (For published work, contact author may have information on support by commercial organization).
Measure Detail
Type of Measure: The activity or area of major concentration Image f3334_SQU.jpg Mortality
Image f3334_SQU.jpg Readmission
Image f3334_SQU.jpg Complication
Image f3334_SQU.jpg length of stay
Image f3334_SQU.jpg avoidable hospitalization
Image f3334_SQU.jpg potentially overused procedure
Image f3334_SQU.jpg potentially underused procedure
Image f3334_SQU.jpg other
Enhancement Area: These are the areas AHCPR has asked us to focus on. You may choose more than one- as many as are applicable. Image f3334_SQU.jpg Chronic medical condition Image f3334_SQU.jpg Avoid. Hospit. Image f3334_SQU.jpg Pediatrics Image f3334_SQU.jpg New Technol. Image f3334_SQU.jpg None
Clinical Domain: One of these options should be chosen based on article. Check all that apply. Image f3334_SQU.jpg Medical Image f3334_SQU.jpg surgical Image f3334_SQU.jpg pediatric Image f3334_SQU.jpg obstetric Image f3334_SQU.jpg psychiatric
Level of Intervention Image f3334_SQU.jpg primary prevention (health promotion, disease prevention)
Image f3334_SQU.jpg secondary prevention (screening, early detection)
Image f3334_SQU.jpg tertiary prevention (optimal treatment of established disease to prevent complications/death)
Measure Rationale.
Scoring method (e.g., percentage, proportion, rank, mean, median, etc.) Image f3334_SQU.jpg rate (events/person-time at risk)
Image f3334_SQU.jpg ratio (events/events, where the numerator is not a subset of the denominator)
Image f3334_SQU.jpg mean
Image f3334_SQU.jpg median
Image f3334_SQU.jpg proportion/percentage (death/complication "rate")
Image f3334_SQU.jpg index or score
Image f3334_SQU.jpg rank or percentile
Image f3334_SQU.jpg range
Image f3334_SQU.jpg standard deviation or variance
Image f3334_SQU.jpg odds ratio or relative risk
Image f3334_SQU.jpg hazard rate
Image f3334_SQU.jpg z score (standardized difference)
Image f3334_SQU.jpg other
Quality Standard: (if suggested a priori by developer or sponsor) Image f3334_SQU.jpg accepted benchmark
Image f3334_SQU.jpg external comparison
Image f3334_SQU.jpg institutional comparison
Numerator Statement: A statement that depicts the portion of the denominator population that satisfies the condition of the performance measure to be an indicator event. (ICD-9 diagnosis or procedure codes, DRG codes, MDC codes, or Revenue Center Codes) 
  
Denominator Statement: A statement that depicts the population evaluated.. (ICD-9 diagnosis or procedure codes, DRG codes, MDC codes, CPT or Revenue Center Codes) 
Population Inclusions (numerator): Additional information describing the population(s) not contained in the numerator statement. 
Population Inclusions (denominator): Additional information describing the population(s) not contained in the denominator statement 
Population Exclusions (numerator): Additional information describing the population(s) that should not be included in the numerator 
Population Exclusions (denominator): Additional information describing the population(s) that should not be included in the denominator 
Longitudinal Data Required: The measure requires the ability to match patient discharges over time Image f3334_SQU.jpg yes
Image f3334_SQU.jpg no
Additional Data Sources Required: (e.g., area population counts, etc.) Check all that apply, indicate specific data source (e.g. population/ census birth certificate) Image f3334_SQU.jpg population/ census: __________________
Image f3334_SQU.jpg chart data: _________________________
Image f3334_SQU.jpg lab data: __________________________
Image f3334_SQU.jpg pharmacy data: _____________________
Image f3334_SQU.jpg outpatient data: _____________________
Image f3334_SQU.jpg other: _____________________________
Extent of prior use: (e.g., number/type of organizations) Image f3334_SQU.jpg None
Image f3334_SQU.jpg Single Site
Image f3334_SQU.jpg Single organization/ Multiple Sites
Image f3334_SQU.jpg Multiple organizations
Current Status Image f3334_SQU.jpg measure defined but not pilot tested
Image f3334_SQU.jpg pilot testing complete but not implemented
Image f3334_SQU.jpg implemented without pilot testing
Image f3334_SQU.jpg tested and implemented and still in use
Image f3334_SQU.jpg tested and implemented but discontinued
Scientific support for measure (e.g., expert panel, published guideline, clinical trials, other empiric research) Check all that apply Image f3334_SQU.jpg published guideline(s)
Image f3334_SQU.jpg clinician/expert panel(s)
Image f3334_SQU.jpg review of published literature (especially RCTs or equivalent)
Image f3334_SQU.jpg application or revision of pre-existing instruments or measures
Image f3334_SQU.jpg consensus within user group
Image f3334_SQU.jpg theory/concept only
Reference Citations: List the publications according to the style from the software program EndNote.
Validity Image f3334_SQU.jpg face validity
Image f3334_SQU.jpg consensual validity
Image f3334_SQU.jpg criterion validity (gold standard measure)
Image f3334_SQU.jpg predictive validity
Image f3334_SQU.jpg construct validity (correlated with other measures in the absence of a gold standard)
Image f3334_SQU.jpg other
Image f3334_SQU.jpg none
Risk Adjustment: Image f3334_SQU.jpg none
Image f3334_SQU.jpg stratified/subgroup analysis
Image f3334_SQU.jpg paired/matched data at patient level
Image f3334_SQU.jpg risk-adjustment using publicly or commercially available software
Image f3334_SQU.jpg risk-adjustment devised specifically for this measure and condition
Abstractor Comments: 

Risk-Adjustment Method Data Collection Instrument
UCSF-Stanford EPC/AHCPR HCUP QI

Risk-Adjustment Method Header
Method Name: 
Method Code: System assigned
Year Developed: 
Year Most Recently Update (" Update"= Change in risk adjustment strategy) (if applicable) 
Developer
  Organization (ie. JCAHO, NCQA)
  First Author
  Affiliation (University, Dept.)
  Address
  Phone
  Email
 
Contact
  Name
  Affiliation (University, Dept.)
  Address
  Phone
  Email
 
Technical Support Available: Image f3334_SQU.jpg YES Image f3334_SQU.jpg NO Image f3334_SQU.jpg Unclear (inquire with developer)
Image f3334_SQU.jpg Public Domain Image f3334_SQU.jpg Proprietary
Risk-Adjustment Method Detail
Adjustment Rationale: An explanation of why the adjustment is necessary to reduce or remove the influences of confounding patient factors 
Classification or analytic approach (e.g., stratification (number of strata), logistic regression, linear regression, etc.) Check all that apply Image f3334_SQU.jpg Stratification
Image f3334_SQU.jpg Logistic regression
Image f3334_SQU.jpg Linear regression
Image f3334_SQU.jpg Other
System development method (e.g., empirical model, score based on empirical model, clinical judgment, etc.) Check all that apply Image f3334_SQU.jpg Logistic regression
Image f3334_SQU.jpg Score based on empirical model
Image f3334_SQU.jpg A priori/ Clinical Judgement
Image f3334_SQU.jpg Other
Published performance: discrimination (e.g., the extent to which the model predicts higher probabilities of an event for those who experience the event) 
Published performance: calibration (e.g., does the mean of the predicted equal the mean of the actual for the entire population and for population subgroups) 
Co-morbidities: Pre-existing diseases or conditions 
Severity of Illness Classification: (AJCC staging, ASA-PS classification for surgical patients) 
Patient Demographics (e.g., age and gender) 
Longitudinal Data Required: The measure requires the ability to match patient discharges over time Image f3334_SQU.jpg Yes
Image f3334_SQU.jpg No
Additional Data Sources Required: (e.g.,chart review, registry data) Check all that apply, indicate specific data source (e.g. population/ census birth certificate) Image f3334_SQU.jpg population/ census: __________________
Image f3334_SQU.jpg chart data: ________________________
Image f3334_SQU.jpg lab data: __________________________
Image f3334_SQU.jpg pharmacy data: _____________________
Image f3334_SQU.jpg outpatient data: _____________________
Image f3334_SQU.jpg other: ____________________________
Extent of prior or current use: (e.g., number/type of organizations) Image f3334_SQU.jpg None
Image f3334_SQU.jpg Single Site
Image f3334_SQU.jpg Single organization/ Multiple Sites
Image f3334_SQU.jpg Multiple organizations
Reference Citations: List the publications according to the style from the software program EndNote.
Abstractor Comments: 

Screener's Initials:
Date Screened:

Indicator Data Screening Instrument
UCSF-Stanford EPC/AHCPR HCUP QI

Measure Header
Lead Author: 
Article Title: 
Year Published: 
Measure Detail
Type of Measure: The activity or area of major concentration Image f3334_SQU.jpg Mortality
Image f3334_SQU.jpg Readmission
Image f3334_SQU.jpg Complication
Image f3334_SQU.jpg length of stay
Image f3334_SQU.jpg avoidable hospitalization
Image f3334_SQU.jpg potentially overused procedure
Image f3334_SQU.jpg potentially underused procedure
Image f3334_SQU.jpg other
Type of Measure: (structure/process/proxy-outcome/outcome) 
Enhancement Area: These are the areas AHCPR has asked us to focus on. You may choose more than one- as many as are applicable. Image f3334_SQU.jpg Chronic medical condition Image f3334_SQU.jpg Avoid. Hospit. Image f3334_SQU.jpg Pediatrics Image f3334_SQU.jpg New Technol. Image f3334_SQU.jpg None
Clinical Domain: One of these options should be chosen based on article. Image f3334_SQU.jpg Medica l Image f3334_SQU.jpg surgical Image f3334_SQU.jpg pediatric Image f3334_SQU.jpg obstetric Image f3334_SQU.jpg psychiatric
Measure Rationale 
Longitudinal Data Required: The measure requires the ability to match patient discharges over time Image f3334_SQU.jpg yes
Image f3334_SQU.jpg no
Additional Data Sources Required: (e.g., area population counts, etc.) Image f3334_SQU.jpg population/ census
Image f3334_SQU.jpg chart data
Image f3334_SQU.jpg lab data
Image f3334_SQU.jpg pharmacy data
Image f3334_SQU.jpg outpatient data
Image f3334_SQU.jpg other

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