Wisconsin Collaborative for Quality Healthcare

Glossary of Terms

A1c

Shorthand for glycated hemoglobin. A1c is a blood test to measure the amount of sugar in the bloodstream over a 3-month period. Glycated hemoglobin is produced when excess glucose attaches itself to red blood cells. A high percentage of glycated hemoglobin indicates potential problems with blood sugar control.

Acute Myocardial Infarction (AMI)

An AMI or heart attack, occurs when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle can't get the oxygen and nutrients it needs, the part of the heart tissue that is affected may die.

Algorithm

A detailed sequence of actions to solve a problem or accomplish a task.

Audit or Data Collection Audit

A systematic inspection of data collection processes and/or medical records to verify the integrity of data reported in the WCHQ Performance & Progress Report.

Beta Blockers

Medicine used to lower blood pressure, treat chest pain and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on the heart by slowing the heart rate and reducing the force with which the heart muscles contract to pump blood.

Blood Culture

A blood test to detect bacteria in the blood.

Centers for Medicare and Medicaid (CMS)

The federal agency that runs the Medicare program for the elderly aged and disabled. In addition, CMS works with the states to run the Medicaid program for low-income individuals.

Congestive Heart Failure (CHF)

Congestive heart failure, or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. The "failing" heart keeps working but not as efficiently as it should.

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

A public-private initiative that develops standardized surveys to evaluate consumer (patient) experiences with healthcare. These surveys cover topics that are important to consumers, like the communication skills of providers and accessibility of care. CAHPS results assist healthcare organizations, public and private purchasers, consumers and researchers to (1) assess the patient-centeredness of care, (2) compare and report on performance and (3) improve the quality of care. The CAHPS program is funded and administered by the U.S. Agency for Healthcare Research and Quality (AHRQ), working closely with a consortium of public and private organizations.

Criteria

Attributes or rules that serve as the basis for evaluation, definition or classification of something; evaluation standards.

Denominator

The number below the line in a fraction. Denotes how many parts make up the whole.

Diabetes

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is required to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

Economic Efficiency

The direct and indirect costs of high quality healthcare.

Effectiveness

Institute of Medicine category that calls for providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit.

Healthcare Effectiveness Data and Information Set (HEDIS)

A set of measures used by more than 90 percent of U.S. health plans to evaluate performance on important dimensions of care and service. HEDIS measures are developed by the National Committee for Quality Assurance (NCQA). The WCHQ website displays HEDIS results from commercial health maintenance organizations (HMOs). In some cases, health plans may report combined results for commercial HMOs and places of service (POS).

Health Plan

An organization that offers reimbursement for its members' health care services. It can be a health maintenance organization (HMO), a preferred provider organization (PPO), a commercial insurance carrier or a company that self-insures.

Institute of Medicine (IOM)

An organization within the National Academy of Sciences that acts as an advisor in health and medicine and conducts policy studies relevant to health issues. The IOM was chartered in 1970 by National Academy of Science to enlist distinguished members of appropriate professions in the examination of policy matters pertaining to the health of the public. The IOM is an advisor to federal government on issues of medical care, research and education.

Leapfrog Group

More than 160 organizations that buy health care who are working to initiate breakthrough improvements in the safety, quality and affordability of healthcare for Americans.

Left Ventricular Function Assessment (LVF)

A test to check how well the heart is pumping.

LDL Cholesterol

Low-density lipoprotein cholesterol, or LDL cholesterol (sometimes called bad cholesterol), is a lipid that narrows or blocks your blood vessels. Blocked vessels can lead to a heart attack or a stroke. Reaching your LDL cholesterol target, usually below 130, is the most effective way to protect your heart and blood vessels.

Measurement

The process of collecting data to assess performance conducted at a single point in time or repeated over time.

n

The number of patients included in the sample size population; where possible and appropriate, the sample size is statistically significant.

N

The total patient population for an Organization; not a statistical sample.

Numerator

The number above the line in a fraction. Denotes the number of parts out of the whole that are being counted.

Outcome Measure

A measure that indicates the result of a process.

Oxygenation Assessment

Test that measures the amount of oxygen in your blood.

Patient-Centeredness

Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring the patient's values guide all clinical decisions.

Percent

A percent is a ratio of a number to 100 expressed using the percent symbol %.

Percentile

A percentile rank is the percentage of scores that fall below a given score. For example, a raw score of 75 on a test might be transformed into a percentile rank of 98 and interpreted as "You did better than 98% of the students who took this test."

Percutaneous Coronary Intervention (PCI)

A procedure, such as angioplasty, that opens a blocked blood vessel.

Performance Measure

Provides an indication (e.g., rate, ratio, index, percentage) of an organization's/or provider's ability to provide care most likely to ensure a good patient outcome.

Physician Quality Reporting System (PQRS)

The Physician Quality Reporting System, formerly called the Physician Quality Reporting Initiative (PQRI), is a voluntary quality reporting program that provides an incentive payment to identified individual eligible professionals and group practices who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-For-Service (FFS) beneficiaries.

Pneumonia

An inflammation of the lungs caused by a viral, bacterial, or fungal infection, which lowers the oxygen level in the blood.

Pneumonia (pneumococcal) Vaccination

Vaccine given to prevent pneumonia.

Process Measure

A series of actions, functions or changes, which lead to a certain anticipated outcome. A scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome.

Quality

Quality health care is how well a doctor, hospital, health plan, or other provider of health care, keeps its members healthy or treats them when they are sick. Good quality health care means doing the right thing at the right time, in the right way, for the right person and getting the best possible results.

Risk-adjustment

A tool to account for patient-related variation (age, sex, additional diseases) when comparing different populations of patients (example, physician group A and physician group B.

Safety

The avoidance of injuries to patients from the care that is intended to help them.

The Society of Thoracic Surgeons (STS)

The Society of Thoracic Surgeons is a not-for-profit organization representing almost 6,000 surgeons, researchers, and allied health professionals worldwide who are dedicated to ensuring the best possible heart, lung, esophageal, and other surgical procedures for the chest. The mission of STS is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

Specifications

A definition of the data elements, data sources, timing and frequency of data collection and reporting for the WCHQ Performance & Progress Report.

Target Population

The numerator (cases) and denominator (population sample meeting specified criteria) of the measure.

The Joint Commission (TJC)

An independent, not-for-profit organization that provides healthcare accreditation and related services to support performance improvement within healthcare organizations. TJC is the nation's primary standards-setting and accrediting body in healthcare; it evaluates and accredits nearly 15,000 U.S. healthcare organizations and programs.

Timeliness

The ability to provide the appropriate care when it is needed.