Clinical Quality Core Measures

Twelve performance measures are currently in use across HRSA service delivery grant programs, including the health center, rural health and health information technology programs.

They address priority health conditions experienced disproportionately by underserved people and may be used by all safety net providers to improve clinical care. The measures focus on prevention and chronic disease management.

They are consistent with national quality measures endorsed by the National Quality Forum, AQA and other national health care quality organizations.

• First Trimester Care
  Percentage of pregnant women beginning prenatal care in the first trimester.
  Numerator: Number of patients who began prenatal care in the first trimester.
  Denominator: Number of patients who entered prenatal care during the measurement year.  
  
• HIV Perinatal Prevention
  HIV screen-pregnant women
  Percentage of patients who were screened for HIV infection during the first or second prenatal care visit.
  Numerator: Number of patients who were screened for HIV infection during the first or second prenatal care visit.
  Denominator: All patients seen for two prenatal visits during the measurement year.

Cancer

• Breast Cancer
  Percentage of women 40-69 years of age who had a mammogram.
  Numerator: One or more mammograms during the measurement year or the year prior to the measurement year.
  Denominator: All female patients aged 42 to 52 and 53 to 69 years of age at the beginning of the measurement year or year prior to the measurement year.
  OR
  Cervical Cancer
  Percentage of women 21-64 years of age who received one or more Pap tests.
  Numerator: One or more Pap tests during the measurement year or the two years prior to the measurement year.
  Denominator: All female patients age 24-64 years of age during the measurement year.
  OR
  Colorectal Cancer
  Percentage of adults 50-80 years of age who had an appropriate screening for colorectal cancer.
  Numerator: One or more screenings for colorectal cancer.
  Denominator: All patients age 51-80 years during the measurement year.  

Immunizations 

• Age Appropriate Immunizations
  Percentage of patients with appropriate immunizations documented according to age and risk group. (or as per ACIP* and/or NVAC guidelines)
  Children
  Percentage of children 2 years of age with appropriate immunizations.
  Numerator: Number of children who have received 4xDTaP/DT, 3xIPV, 1xMMR, 3xHiB, 3xHepB, 1xVZV, and 4x PCV vaccines by their second birthday.
  Denominator: All children who turn 2 years of age during the measurement year.
  OR
  Adult
  Percentage of patients 50-64 years and 65 and above who have received influenza vaccine.
  Numerator: Number of patients who received influenza vaccination from September through February of the year prior to the measurement period.
  Denominator: All patients 50-64 years and 65 and above at the beginning of the 1-year measurement period.
  OR
  Geriatrics
  Percentage of patients = 65 years of age who have ever received pneumococcal vaccine.
  Numerator: Number of patients who have ever received pneumococcal vaccine.
  Denominator: All patients 65 years and older in the measurement year.
  OR
  HIV/AIDS
  Percentage of patients with HIV infection who completed the vaccinations series for Hepatitis B.
  Numerator: Number of patients with HIV/AIDS who were vaccinated for Hepatitis B (vaccine Bx3 vaccinations).
  Denominator: All patients with HIV/AIDS in the measurement year who are documented to be susceptible to Hepatitis B virus or have an unknown Hepatitis B status.

• HbA1c Control
  Percentage of adult patients with type 1 or 2 diabetes, with most recent hemoglobin A1c (HbA1c) greater than 9% (poor control).
  Numerator: Number of adult patients whose most recent hemoglobin A1c level during the measurement year is greater than 9%.
  Denominator: Number of adult patients 18-75 years of age as of December 31 of the measurement year with a diagnosis of type 1 or 2 diabetes.  

Cardiovascular-Hypertension

• Cardiovascular-Hypertension
  Percentage of adult patients, 18 years and older, with diagnosed hypertension (HTN) whose blood pressure (BP) was less than 140/90 (adequate control).
  Numerator: Patients with last systolic blood pressure measurement less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg during the measurement year.
  Denominator: All patients = 18 years of age as of December 31 of the measurement year with diagnosis of hypertension (HTN).