ALS Patient Care Preferences

Measure Purpose: Ensure patients are routinely offered assistance in planning for end-of-life issues or their existing end-of-life plan was reviewed and updated at least once. 

The numerator: patients who were offered assistance in planning for end-of-life issues (e.g., advance directives, invasive ventilation, lawful physician-hastened death, or hospice) or whose existing end-of-life plan was reviewed and updated at least once annually or more frequently as clinically indicated (i.e., rapid progression).

is divided by

The denominator: patients diagnosed with ALS phenotypes characterized by appropriate ICD codes

Exclusions:

• Admitted to hospice

Exceptions: 

• Annual discussion not clinically indicated

Key Phrases

Example of key phrases you could use to meet the measure include:

• Discussion about hospice
• Healthcare power of attorney reported

Measure Calculation Example

Dr. Murakami has 95 visits between January 1 and December 31 with patients diagnosed with ALS phenotypes characterized by appropriate ICD codes. This is the denominator.

Of these 95 patients, 2 were admitted to hospice that year and 3 had no clinical indications for a discussion. These exceptions are removed from the denominator (95-5=90).

Of the remaining 90 patients, Dr. Murakami offered assistance in planning for end-of-life issues or updated an existing end-of-life plan for 71.

Quality of patient care = 71/90. Dr. Murakami has a score of 78.9% for this measure.