Immunosuppressive treatment for GBs

Measure Purpose: Decrease the duration of functional impairment in Guillain-Barre Syndrome (GBS)

The numerator: Patients admitted to an inpatient facility with GBS who are nonambulatory with documentation that immunosuppressive therapy using plasmapheresis (PE) or intravenous immunoglobulin (IVIG) given and not prescribed corticosteroids

is divided by

The denominator: Patients admitted to inpatient facility with confirmed diagnosis of GBS who are nonambulatory

Exclusions are removed from the denominator for:

Alternative diagnosis suspected and treated
GBS refractory to first line treatments
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 that are beyond four weeks of onset
Patients who refuse

Key Phrases

Key phrases you should use to meet this measure include:

Patient prescribed immunosuppressive therapy
Patient prescribed plasmapheresis
Patient prescribed PE
Patient prescribed IVIG
Patient prescribed intravenous immunoglobulin

Measure Calculation Example

Dr. Sousa has 13 patients on his hospital service with a confirmed diagnosis of Guillain-Barre Syndrome. This is the denominator. One patient cannot tolerate central line placement and one is beyond 4 weeks of onset. These two patients are removed from the denominator.

Of the remaining 11 patients, six of them received PE and one received IVIG. This is the numerator.

Quality of patient care = 7/(13-2). Dr. Sousa has a score of 63% for this measure.