Wisconsin Collaborative for Quality Healthcare

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MEASURES CLINICAL TOPIC MEASURE TYPE IOM IMPROVEMENT AIM Rollover for more information
Adolescent Immunizations
Adolescent Immunization Status For the general community, high childhood immunization rates prevent the resurgence of many infectious diseases, such as polio, that have been virtually eradicated from most developed countries (CDC, 1999). The general clinical consensus is that if immunization practices ceased, most infectious and contagious diseases currently prevented by vaccinations would reemerge as lethal health threats. Potential for exposure to infectious disease is even greater with the increase in international travel. By ensuring proper immunization of adolescents, organizations can help contain the transmission of these diseases and help protect the general population. This measure assesses the percentage of adolescents who had each of the following immunizations by their 13th birthday: One dose of meningococcal vaccine AND, One tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) OR, One tetanus, diphtheria toxoids vaccine (Td) This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Adult BMI Screening (WCHQ)
Adult Body Mass Index (BMI) Control The United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services, June 2012, recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. In addition, the Institute for Clinical Systems Improvement (ICSI, 2011) Prevention and Management of Obesity (Mature Adolescents and Adults) provides the following guidance: *Calculate the body mass index; classify the individual based on the body mass index categories. Educate patients about their body mass index and their associated risks. *Weight management requires a team approach. Be aware of clinical and community resources. The patient needs to have an ongoing therapeutic relationship and follow-up with a health care team. *Weight control is a lifelong commitment, and the health care team can assist with setting specific goals with the patient.BMI Parameters: *Normal Parameters: 18-64 years BMI >=18.5 and <25, 65 years and older BMI >=23 and <30 *Above Normal Parameters: 18-64 years BMI >=25, 65 years and older BMI >=30 *Below Normal Parameters: 18-64 years BMI <18.5, 65 years and older BMI<23 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Adult Body Mass Index (BMI) Screening Annually The United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services, June 2012, recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults.

In addition, the Institute for Clinical Systems Improvement (ICSI, 2011) Prevention and Management of Obesity (Mature Adolescents and Adults) provides the following guidance: *Calculate the body mass index; classify the individual based on the body mass index categories. Educate patients about their body mass index and their associated risks. *Weight management requires a team approach. Be aware of clinical and community resources. The patient needs to have an ongoing therapeutic relationship and follow-up with a health care team. *Weight control is a lifelong commitment, and the health care team can assist with setting specific goals with the patient.

This measure assesses adults ages 18 through 85 who have had a minimum of one BMI Test annually.
 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive CareMedical GroupEffectiveness
Breast Cancer Screening
Breast Cancer Screening There is convincing evidence that screening with film mammography reduces breast cancer mortality, with a greater absolute reduction for women aged 50 to 74 years than for women aged 40 to 49 years. The strongest evidence for the greatest benefit is among women aged 60 to 69 years. Among women 75 years or older, evidence of benefits of mammography is lacking.Recommended intervals for mammography screening may also vary on an individual basis, but there is a general consensus that every two years is the minimum frequency. However, it is recommended that women speak with their health care providers to determine on an individual basis the age at which to begin and end mammography screening and the frequency of these screenings. For women who have had sporadic breast cancer the evidence supports regular history, physical examination, and mammography as the cornerstone of appropriate breast cancer follow-up. Women treated with breast-conserving therapy should have their first post-treatment mammogram no earlier than 6 months after definitive radiation therapy. Subsequent mammograms should be obtained every 6 to 12 months for surveillance of abnormalities. Mammography should be performed yearly if stability of mammographic findings is achieved after completion of loco regional therapy.This measure assesses the percentage of women age 50 through 74 who had a minimum of one breast cancer screening test during the two year measurement period This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Cervical Cancer Screening
Cervical Cancer Screening There is good evidence that cervical cancer screening significantly reduces the incidence of and mortality from cervical cancer. The US Preventive Services Task Force suggests most of the benefit can be obtained by beginning screening at age 21. Recommendations include screening for women ages 21 through 64 with cytology (Pap smear) at least every 3 years and for women ages 30 through 64 who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. An individuals specific clinical considerations, risk factors, etc. determine if testing is needed at a more frequent interval. It is recommended that women speak with their health care providers to determine the appropriate interval for their particular situation. There is limited evidence to determine the benefits of continued screening in women older than 65, due to declining incidence of high-grade cervical lesions after middle age. There is fair evidence that screening women older than 65 is associated with an increased risk for potential harm (US Preventive Services Task Force). Therefore, it is also recommended that women over age 65 speak with their health care providers to determine if continued screening is appropriate for their personal medical condition. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Childhood Immunizations
Childhood Immunization Status For the general community, high childhood immunization rates prevent the resurgence of many infectious diseases, such as polio, that have been virtually eradicated from most developed countries (CDC, 1999). The general clinical consensus is that if immunization practices ceased, most infectious and contagious diseases currently prevented by vaccinations would reemerge as lethal health threats. Potential for exposure to infectious disease is even greater with the increase in international travel. By ensuring proper immunization of children by the age of two, health organizations can help contain the transmission of these diseases and help protect the general population. This measure assesses completion of the Primary Childhood Series for children age two who have had each of the following immunizations: *Four Diphtheria Tetanus and Acellular Pertussis (DTaP) *Three Polio (IPV) *One Measles, Mumps and Rubella (MMR) *Three H influenza Type B (HiB) *Three Hepatitis B (Hep B) *One Chicken Pox/Varicella (VZV) *Four Pneumococcal Conjugate (PCV)  This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Chlamydia Screening in Women (WCHQ)
Chlamydia Screening in Women Sexually transmitted infections (STIs) cause significant morbidity and mortality in the United States each year. The Centers for Disease Control and Prevention (CDC) estimates that 19 million new infections occur annually in the United States, almost one half of which occur in persons 15 to 24 years of age.

Chlamydia is a common STD that can infect both men and women. It can cause serious, permanent damage to a woman's reproductive system, making it difficult or impossible for her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb).

Because chlamydia is usually asymptomatic, screening is necessary to identify most infections. Screening programs have been demonstrated to reduce rates of adverse secondary consequences in women. CDC recommends yearly chlamydia screening of all sexually active women younger than 25.

This measure assesses women 16 through 24 years of age identified as sexually active who had at least one test for chlamydia during the 12-month measurement period.

 New Measure! This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive CareMedical GroupEffectiveness
Colorectal Cancer Screening
Colorectal Cancer Screening The United States Preventive Services Task Force (USPSTF) strongly recommends that clinicians screen men and women, at age 50 and older for colorectal cancer. The optimal interval for screening depends on the test. Annual fecal occult blood testing (FOBT)/Fecal Immunoassay Test (FIT) offers greater reductions in mortality rates than biennial screening. A 10-year interval has been recommended for colonoscopy, but a 5-year interval is recommended for flexible sigmoidoscopies because of their lower sensitivity. Fecal DNA Screening (Cologuard test) has been added as a new option for screening in 2015 (recommended interval every three years). The USPSTF concluded that the benefits from screening for colorectal cancer substantially outweigh potential harms, and that regardless of screening strategy chosen, it is likely to be cost-effective. In persons identified as being at high-risk by their health care providers, initiating screening at an earlier age is reasonable. It is recommended that all adults speak with their health care providers to determine, on an individual basis, the age at which to begin and end screenings, the best type of screening for individual circumstances, and the frequency of these screenings. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Screening For Depression (WCHQ)
Screening For Clinical Depression Adolescent Recommendation (12-18 years)
The United States Preventive Services Task Force (USPSTF) recommends screening of adolescents (12-18 years of age) for major depressive disorder (MDD) when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and follow-up.

Adult Recommendation (18 years and older)
The USPSTF recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up.

 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive CareMedical GroupEffectiveness
Osteoporosis Screening
Screening for Osteoporosis The USPSTF (US Preventive Services Task Force) found good evidence that the risk for osteoporosis and fracture increases with age (and other factors). They also found that bone density measurements accurately predict the risk for fractures in the short-term and that treating asymptomatic women with osteoporosis reduces their risk for fracture. The benefits of screening and treatment are of at least moderate magnitude for women at increased risk by virtue of age or the presence of other risk factors. No recommendation has been made by the USPSTF for or against screening for osteoporosis in postmenopausal women younger than 60 or in women 60-64 who are not at increased risk for an osteoporotic fracture. The National Osteoporosis Foundation recommends a bone density screening for all women at 65 years and older regardless of their risk factors. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive CareMedical GroupEffectiveness
Well Child Visit First 15 Months (WCHQ)
Well Child Visit First 15 Months of Life This measure is based on the CMS and American Academy of Pediatrics guidelines for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) visits which outlines the following benefits of Well-Child Visits: *Prevention. Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school. *Tracking growth and development. See how much your child has grown in the time since your last visit, and talk with your doctor about your childs development. You can discuss your childs milestones, social behaviors and learning. *Raising concerns. Make a list of topics you want to talk about with your childs pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit. *Team approach. Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child. * It is recommended that visits in the first 15 months of life occur at the following ages: By 1 month, 2 months, 4 months, 6 months, 9 months, 12 months and 15 months.

This measure assesses the percentage of pediatric patients who turned 15 months old during the measurement period and who had six or more well-child visits with a PCP during their first 15 months of life (by their 15 month birthday).

 New Measure! This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive CareMedical GroupEffectiveness
Adult Pneumococcal Vaccination
Adults with Pneumococcal Vaccinations Pneumococcal disease is a significant cause of morbidity and mortality in the United States. Streptococcus pneumoniae accounts for 20% to 60% of all community-acquired bacterial pneumonias (CAP) in adults. The risks for complications, hospitalizations, and death from pneumococcus pneumonia are higher among persons aged >65 years. The pneumococcal vaccine protects against the Streptococcus pneumoniae.

This measure assesses the percentage of adults greater than or equal to 65 years who had a pneumococcal vaccination.
 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive CareMedical GroupEffectiveness
Tobacco Cessation
Tobacco User Receiving Tobacco Cessation Advice Tobacco use has been cited as the chief avoidable cause of illness and death in our society. Each year in the United States, more than 435,000 deaths are attributed to tobacco use. Smoking-attributable health care expenditures are estimated at $96 billion per year in direct medical expenses and $97 billion in lost productivity. Epidemiological data suggest that more than 70 percent of the 45 million current smokers in the United States report a desire to quit. It is important for clinicians to know that assessing and treating tobacco use leads to greater patient satisfaction with health care.

This measure assesses the percentage of patients age 18 to 85 years of age identified as tobacco users who received tobacco cessation intervention advice during the 12 month measurement period.
 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive CareMedical GroupEffectiveness
CLINIC
Adolescent Immunization Status For the general community, high childhood immunization rates prevent the resurgence of many infectious diseases, such as polio, that have been virtually eradicated from most developed countries (CDC, 1999). The general clinical consensus is that if immunization practices ceased, most infectious and contagious diseases currently prevented by vaccinations would reemerge as lethal health threats. Potential for exposure to infectious disease is even greater with the increase in international travel. By ensuring proper immunization of adolescents, organizations can help contain the transmission of these diseases and help protect the general population. This measure assesses the percentage of adolescents who had each of the following immunizations by their 13th birthday: One dose of meningococcal vaccine AND, One tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) OR, One tetanus, diphtheria toxoids vaccine (Td) This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Adult Body Mass Index (BMI) Control The United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services, June 2012, recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. In addition, the Institute for Clinical Systems Improvement (ICSI, 2011) Prevention and Management of Obesity (Mature Adolescents and Adults) provides the following guidance: *Calculate the body mass index; classify the individual based on the body mass index categories. Educate patients about their body mass index and their associated risks. *Weight management requires a team approach. Be aware of clinical and community resources. The patient needs to have an ongoing therapeutic relationship and follow-up with a health care team. *Weight control is a lifelong commitment, and the health care team can assist with setting specific goals with the patient.BMI Parameters: *Normal Parameters: 18-64 years BMI >=18.5 and <25, 65 years and older BMI >=23 and <30 *Above Normal Parameters: 18-64 years BMI >=25, 65 years and older BMI >=30 *Below Normal Parameters: 18-64 years BMI <18.5, 65 years and older BMI<23 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Adult Body Mass Index (BMI) Screening Annually The United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services, June 2012, recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults.

In addition, the Institute for Clinical Systems Improvement (ICSI, 2011) Prevention and Management of Obesity (Mature Adolescents and Adults) provides the following guidance: *Calculate the body mass index; classify the individual based on the body mass index categories. Educate patients about their body mass index and their associated risks. *Weight management requires a team approach. Be aware of clinical and community resources. The patient needs to have an ongoing therapeutic relationship and follow-up with a health care team. *Weight control is a lifelong commitment, and the health care team can assist with setting specific goals with the patient.

This measure assesses adults ages 18 through 85 who have had a minimum of one BMI Test annually.
 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive Care ClinicEffectiveness
Breast Cancer Screening There is convincing evidence that screening with film mammography reduces breast cancer mortality, with a greater absolute reduction for women aged 50 to 74 years than for women aged 40 to 49 years. The strongest evidence for the greatest benefit is among women aged 60 to 69 years. Among women 75 years or older, evidence of benefits of mammography is lacking.Recommended intervals for mammography screening may also vary on an individual basis, but there is a general consensus that every two years is the minimum frequency. However, it is recommended that women speak with their health care providers to determine on an individual basis the age at which to begin and end mammography screening and the frequency of these screenings. For women who have had sporadic breast cancer the evidence supports regular history, physical examination, and mammography as the cornerstone of appropriate breast cancer follow-up. Women treated with breast-conserving therapy should have their first post-treatment mammogram no earlier than 6 months after definitive radiation therapy. Subsequent mammograms should be obtained every 6 to 12 months for surveillance of abnormalities. Mammography should be performed yearly if stability of mammographic findings is achieved after completion of loco regional therapy.This measure assesses the percentage of women age 50 through 74 who had a minimum of one breast cancer screening test during the two year measurement period This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Cervical Cancer Screening There is good evidence that cervical cancer screening significantly reduces the incidence of and mortality from cervical cancer. The US Preventive Services Task Force suggests most of the benefit can be obtained by beginning screening at age 21. Recommendations include screening for women ages 21 through 64 with cytology (Pap smear) at least every 3 years and for women ages 30 through 64 who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years. An individuals specific clinical considerations, risk factors, etc. determine if testing is needed at a more frequent interval. It is recommended that women speak with their health care providers to determine the appropriate interval for their particular situation. There is limited evidence to determine the benefits of continued screening in women older than 65, due to declining incidence of high-grade cervical lesions after middle age. There is fair evidence that screening women older than 65 is associated with an increased risk for potential harm (US Preventive Services Task Force). Therefore, it is also recommended that women over age 65 speak with their health care providers to determine if continued screening is appropriate for their personal medical condition. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Childhood Immunization Status For the general community, high childhood immunization rates prevent the resurgence of many infectious diseases, such as polio, that have been virtually eradicated from most developed countries (CDC, 1999). The general clinical consensus is that if immunization practices ceased, most infectious and contagious diseases currently prevented by vaccinations would reemerge as lethal health threats. Potential for exposure to infectious disease is even greater with the increase in international travel. By ensuring proper immunization of children by the age of two, health organizations can help contain the transmission of these diseases and help protect the general population. This measure assesses completion of the Primary Childhood Series for children age two who have had each of the following immunizations: *Four Diphtheria Tetanus and Acellular Pertussis (DTaP) *Three Polio (IPV) *One Measles, Mumps and Rubella (MMR) *Three H influenza Type B (HiB) *Three Hepatitis B (Hep B) *One Chicken Pox/Varicella (VZV) *Four Pneumococcal Conjugate (PCV)  This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Chlamydia Screening in Women Sexually transmitted infections (STIs) cause significant morbidity and mortality in the United States each year. The Centers for Disease Control and Prevention (CDC) estimates that 19 million new infections occur annually in the United States, almost one half of which occur in persons 15 to 24 years of age.

Chlamydia is a common STD that can infect both men and women. It can cause serious, permanent damage to a woman's reproductive system, making it difficult or impossible for her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb).

Because chlamydia is usually asymptomatic, screening is necessary to identify most infections. Screening programs have been demonstrated to reduce rates of adverse secondary consequences in women. CDC recommends yearly chlamydia screening of all sexually active women younger than 25.

This measure assesses women 16 through 24 years of age identified as sexually active who had at least one test for chlamydia during the 12-month measurement period.

 New Measure! This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive Care ClinicEffectiveness
Colorectal Cancer Screening The United States Preventive Services Task Force (USPSTF) strongly recommends that clinicians screen men and women, at age 50 and older for colorectal cancer. The optimal interval for screening depends on the test. Annual fecal occult blood testing (FOBT)/Fecal Immunoassay Test (FIT) offers greater reductions in mortality rates than biennial screening. A 10-year interval has been recommended for colonoscopy, but a 5-year interval is recommended for flexible sigmoidoscopies because of their lower sensitivity. Fecal DNA Screening (Cologuard test) has been added as a new option for screening in 2015 (recommended interval every three years). The USPSTF concluded that the benefits from screening for colorectal cancer substantially outweigh potential harms, and that regardless of screening strategy chosen, it is likely to be cost-effective. In persons identified as being at high-risk by their health care providers, initiating screening at an earlier age is reasonable. It is recommended that all adults speak with their health care providers to determine, on an individual basis, the age at which to begin and end screenings, the best type of screening for individual circumstances, and the frequency of these screenings. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Screening For Clinical Depression Adolescent Recommendation (12-18 years)
The United States Preventive Services Task Force (USPSTF) recommends screening of adolescents (12-18 years of age) for major depressive disorder (MDD) when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and follow-up.

Adult Recommendation (18 years and older)
The USPSTF recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up.

 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive Care ClinicEffectiveness
Screening for Osteoporosis The USPSTF (US Preventive Services Task Force) found good evidence that the risk for osteoporosis and fracture increases with age (and other factors). They also found that bone density measurements accurately predict the risk for fractures in the short-term and that treating asymptomatic women with osteoporosis reduces their risk for fracture. The benefits of screening and treatment are of at least moderate magnitude for women at increased risk by virtue of age or the presence of other risk factors. No recommendation has been made by the USPSTF for or against screening for osteoporosis in postmenopausal women younger than 60 or in women 60-64 who are not at increased risk for an osteoporotic fracture. The National Osteoporosis Foundation recommends a bone density screening for all women at 65 years and older regardless of their risk factors. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Preventive Care ClinicEffectiveness
Well Child Visit First 15 Months of Life This measure is based on the CMS and American Academy of Pediatrics guidelines for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) visits which outlines the following benefits of Well-Child Visits: *Prevention. Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school. *Tracking growth and development. See how much your child has grown in the time since your last visit, and talk with your doctor about your childs development. You can discuss your childs milestones, social behaviors and learning. *Raising concerns. Make a list of topics you want to talk about with your childs pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit. *Team approach. Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child. * It is recommended that visits in the first 15 months of life occur at the following ages: By 1 month, 2 months, 4 months, 6 months, 9 months, 12 months and 15 months.

This measure assesses the percentage of pediatric patients who turned 15 months old during the measurement period and who had six or more well-child visits with a PCP during their first 15 months of life (by their 15 month birthday).

 New Measure! This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive Care ClinicEffectiveness
Adults with Pneumococcal Vaccinations Pneumococcal disease is a significant cause of morbidity and mortality in the United States. Streptococcus pneumoniae accounts for 20% to 60% of all community-acquired bacterial pneumonias (CAP) in adults. The risks for complications, hospitalizations, and death from pneumococcus pneumonia are higher among persons aged >65 years. The pneumococcal vaccine protects against the Streptococcus pneumoniae.

This measure assesses the percentage of adults greater than or equal to 65 years who had a pneumococcal vaccination.
 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive Care ClinicEffectiveness
Tobacco User Receiving Tobacco Cessation Advice Tobacco use has been cited as the chief avoidable cause of illness and death in our society. Each year in the United States, more than 435,000 deaths are attributed to tobacco use. Smoking-attributable health care expenditures are estimated at $96 billion per year in direct medical expenses and $97 billion in lost productivity. Epidemiological data suggest that more than 70 percent of the 45 million current smokers in the United States report a desire to quit. It is important for clinicians to know that assessing and treating tobacco use leads to greater patient satisfaction with health care.

This measure assesses the percentage of patients age 18 to 85 years of age identified as tobacco users who received tobacco cessation intervention advice during the 12 month measurement period.
 This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).
Preventive Care ClinicEffectiveness