Louisiana Health Care Review
THE MEDICARE QUALITY IMPROVEMENT ORGANIZATION
Hospitals & Inpatient Facilities
Quality Improvement Projects

LHCR provides quality improvement consultation and materials to its provider partners. Here are some of the Health Care Quality Improvement Projects (HCQIP) we are all working on to improve the quality of care for Louisiana hospital patients.

Rural Organization
Safety Culture

 Link to "Vital Smarts: Silence Kills" materials from Health Services Advisory Group (HSAG)

Summary of 8th Scope of Work Hospital Outcomes
LHCR, the Medicare QIO for Louisiana, under the direction of CMS, collaborated with selected groups of hospitals to achieve accelerated improvement in care for patients with AMI, HF and Pneumonia, as well as, culture change to enhance patient safety.

Pneumonia
(and Adult Immunizations)

 National Pneumonia Clinical Indicators and Descriptions, Links to Pneumonia Related Web Sites, and LHCR's Pneumonia Quality Improvement Specialist

Heart Failure

 National Heart Failure Clinical Indicators and Descriptions, Heart Failure Interventions, Links to HF Related Web Sites, and LHCR's HF Quality Improvement Specialist

Acute Myocardial Infarction

 National AMI Clinical Indicators and Descriptions, Test Indicators, Acute Myocardial Infarction Interventions, Links to AMI Related Web Sites, and LHCR's AMI Quality Improvement Specialist

Smoking Cessation

 Links to Smoking Cessation Related Web Sites

Surgical Care Improvement Project (SCIP)

 The Surgical Care Improvement Project is a national quality partnership of organizations focused on improving surgical care by significantly reducing surgical complications. The goal of SCIP is to reduce the incidence of surgical complications nationally by 25% by the year 2010.
30-Day Risk Adjusted Mortality Measures These measures are risk adjusted and are based upon Medicare administrative data including enrollment and claims data. Providers do not need to submit data for these measures to the QIO Clinical Warehouse. Link to QualityNet for these measure details
 
Hospital Consumer Assessment of Healthcare Providers and Systems (H-CAHPS) Survey Per CMS Regulations 1506-FC, RHQDAPU participating providers will be required to submit data for the H-CAHPS initiative in order to receive their full market basket update. Link to H-CAHPS on-line site
Hospital Outpatient Quality Data Reporting Program (HOP QDRP) Link to QualityNet Hospital Outpatient pages
Data Collection & Management - Enhancing Care Through Measurement
LHCR is committed to working with its hospital partners in preparing them for the future public release of quality indicator data. All hospitals, whether JCAHO accredited or not, are encouraged to provide this data either through their vendor or using the CART tool. Find out more here.

QNet Exchange

 A Web-based venue that allows your hospital to exchange secure data files - Get the Details!

CART Data Collection Tool

 CMS has developed the Abstraction & Reporting Tool (CART) to provide hospitals with a way to collect the data
Important Provider Information

Quality Insider Newsletter

 Current and Archived Issues of the LHCR Publication for Health Care Providers (PDF files)

Provider Presentations

 PowerPoint and PDF file presentations from LHCR Staff
HPMP - Hospital Payment Monitoring Program
Program Overview

Learn about the HPMP process.

Resources & Links

 Newsletters, PowerPoint Presentations and more.
HPMP Tools Compliance Workbook, Medicare CoP, etc.
Case Review

Louisiana Health Care Review (LHCR) responsibilities as a Quality Improvement Organization (QIO) are to protect Medicare beneficiaries' rights, improve quality of care, and protect the integrity of the Medicare Trust Fund. Each case reviewed by the QIO is for the purpose of achieving one (or more) of these three objectives.

  Current types of case review include:  
   

Each case is reviewed to determine if admission was appropriate, reasonable, and medically necessary, whether the services met professionally recognized standards of health care, and whether all diagnoses and procedures billed are reflected in the chart documentation.  Currently, Interqual’s Severity of Illness and Intensity of Service (SI/IS) inpatient criteria and invasive procedure criteria are the screening tools employed for utilization issues. CMS generic quality screens are used for quality screening.
Become a Physician Reviewer for LHCR Get the details on how to become a physician reviewer with LHCR through peer review.
 

 


For more Quality Improvement
resources, visit www.medqic.org

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