Immunosuppressive therapy for myasthenic crisis
Measure Purpose: Rapidly initiate treatment for myasthenic crisis and thereby wean from mechanical ventilation, reduce likelihood of tracheostomy, and increase functional independence
The numerator: Patients with myasthenic crisis that are given immunosuppressive therapies (Plasmapheresis (PE) or intravenous immunoglobulin (IVIG))
is divided by
The denominator: Patients admitted to inpatient facility with a diagnosis of myasthenic crisis
Exclusions are removed from the denominator:
- Patient has a previous history of severe systemic or anaphylactic response to IVIG
- Patient is known to have anti-IgA antibodies with selective IgA deficiencies
- Patient cannot tolerate central line placement
- Patient is actively septic or hemodynamically unstable
- Patient has an allergy to fresh frozen plasma or albumin
- Patient has a heparin allergy that prevents receiving heparin as an anticoagulant during plasmapheresis
- Patient with hypocalcemia
- Patients who refuse
Key Phrases
Key phrases you should use to meet this measure include:
- Patient prescribed IVIG
- Patient prescribed intravenous immunoglobulin
- Patient prescribed PE
- Patient prescribed plasmapheresis
- Patient prescribed immunosuppressive therapy
Measure Calculation Example
Dr. Martinez had 7 patients on her inpatient service in myasthenic crisis from January 1 to December 31 of the measurement year. This is the denominator. One patient has and allergy to fresh frozen plasma. This patient is removed from the denominator.
Of the six remaining patients, three of them received IVIG and one received PE.
Quality of care = 4/(7-1). Dr. Martinez has a score of 66% for this measure.