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## Complete Summary

#### TITLE

Pediatric acute gastroenteritis: percentage of patients aged 1 month to
5 years of age with a diagnosis of acute gastroenteritis whose
parent/caregiver received education on diet and when to contact the
physician.

#### SOURCE(S)

American Academy of Pediatrics, American Academy of Family Physicians,
Physician Consortium for Performance Improvement®. Pediatric acute
gastroenteritis physician performance measurement set. Chicago (IL):
American Medical Association (AMA); 2005 May. 7 p. \[1 reference\]

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Process

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of pediatric acute
gastroenteritis patients whose parent/caregiver received education on
diet and when to contact the physician.

#### RATIONALE

According to the American Academy of Pediatrics (AAP) and the U.S.
Centers for Disease Control and Prevention (CDC), as soon as dehydration
is corrected, feeding should begin.

Breastfed infants should continue nursing on demand. Formula-fed infants
should continue their usual formula immediately upon rehydration in
amounts sufficient to satisfy energy and nutrient requirements. Children
receiving solid foods should continue to receive their usual diet during
episodes of diarrhea.

Caregivers should be encouraged to return for medical attention if they
have any concerns, if they are not sure that rehydration is proceeding
well, or if new or worsening symptoms develop.

Successful home management of dehydration associated with acute
gastroenteritis is dependent upon the parent/caregiver receiving proper
education. Instructions regarding the frequency of administration of
appropriate oral hydration solutions (ORS), continuation of regular
diet, and when the parent/caregiver should contact the physician are all
topics that should be covered prior to discharging the child home with
the parent/caregiver.

#### PRIMARY CLINICAL COMPONENT

Pediatric acute gastroenteritis; parent/caregiver education; diet; when
to contact the physician

#### DENOMINATOR DESCRIPTION

All patients aged 1 month to 5 years of age with the diagnosis of acute
gastroenteritis seen in the ambulatory setting\*

\*Ambulatory setting is defined as seen in the physician office or
emergency department and discharged home.

#### NUMERATOR DESCRIPTION

All patients whose parent/caregiver received education on diet and when
to contact the physician

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A clinical practice guideline or other peer-reviewed synthesis of
    the clinical evidence

#### NATIONAL GUIDELINE CLEARINGHOUSE LINK

-   [Managing acute gastroenteritis among children: oral rehydration,
    maintenance, and nutritional
    therapy.](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=4362)

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Use of this measure to improve performance

#### EVIDENCE SUPPORTING NEED FOR THE MEASURE

Northrup RS, Flanigan TP. Gastroenteritis. Pediatr Rev1994
Dec;15(12):461-72. \[10 references\]
[PubMed](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7845868)

Practice parameter: the management of acute gastroenteritis in young
children. American Academy of Pediatrics, Provisional Committee on
Quality Improvement, Subcommittee on Acute Gastroenteritis.
Pediatrics1996 Mar;97(3):424-35.
[PubMed](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8604285)

Snyder JD. Use and misuse of oral therapy for diarrhea: comparison of US
practices with American Academy of Pediatrics recommendations.
Pediatrics1991 Jan;87(1):28-33.
[PubMed](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1984614)

### State of Use of the Measure

#### STATE OF USE

Pilot testing

#### CURRENT USE

Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Emergency Medical Services\
Hospitals\
Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Advanced Practice Nurses\
Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Individual Clinicians

#### TARGET POPULATION AGE

Age 1 month to 5 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Getting Better

#### IOM DOMAIN

Effectiveness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

All patients aged 1 month to 5 years of age with the diagnosis of acute
gastroenteritis

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
All patients aged 1 month to 5 years of age with the diagnosis of acute
gastroenteritis seen in the ambulatory setting\*

\*Ambulatory setting is defined as seen in the physician office or
emergency department and discharged home.

**Exclusions**\
None

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Encounter

#### DENOMINATOR TIME WINDOW

Time window is a single point in time

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
All patients whose parent/caregiver received education on diet and when
to contact the physician

**Exclusions**\
None

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Encounter or point in time

#### DATA SOURCE

Administrative data\
Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Individual Case

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Unspecified

#### STANDARD OF COMPARISON

Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Acute gastroenteritis: education.

#### MEASURE COLLECTION

[The Physician Consortium for Performance Improvement® Measurement
Sets](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1835&doc=178)

#### MEASURE SET NAME

[Pediatric Acute Gastroenteritis Physician Performance Measurement
Set](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1835&doc=9240)

#### SUBMITTER

American Medical Association on behalf of the American Academy of
Pediatrics, the American Academy of Family Physicians, and the Physician
Consortium for Performance Improvement®

#### DEVELOPER

American Academy of Family Physicians\
American Academy of Pediatrics\
Physician Consortium for Performance Improvement®

#### FUNDING SOURCE(S)

Unspecified

#### COMPOSITION OF THE GROUP THAT DEVELOPED THE MEASURE

James Berman, MD, FAAP (*Co-Chair*); Michael Goldberg, MD (*Co-Chair*);
Bruce Bagley, MD; David Classen, MD; Todd Davis, MD, FAAP; Debra Esser,
MD; David G. Jaimovich, MD; Eric Handler, MD, MPH; Mark Hostetler, MD,
MPH; Lowell Keppel, MD, CPE, FACPE, FAAFP; Samuel Kocoshis, MD; Marlene
Miller, MD, MSc, FAAP; Heather Palmer, MD, BCh, SM, FAAP; Sam J.W.
Romeo, MD, MBA; Cheri Throop; Robert Walker, MD, FAAP; Josie Williams,
MD, MMM

Raquel Gabriel-Bennewitz (JCAHO), Liaison; Phill Renner (NCQA), Liaison

Junelle Speller, MPH, American Academy of Pediatrics

Janet Leiker, American Academy of Family Physicians

Erin O. Kaleba, MPH, American Medical Association; Karen Kmetik, PhD,
American Medical Association

Rebecca Kresowik, Consultant; Timothy Kresowik, MD, Consultant

#### FINANCIAL DISCLOSURES/OTHER POTENTIAL CONFLICTS OF INTEREST

Conflicts, if any, are disclosed in accordance with the Physician
Consortium for Performance Improvement® conflict of interest policy.

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2005 May

#### MEASURE STATUS

This is the current release of the measure.

#### SOURCE(S)

American Academy of Pediatrics, American Academy of Family Physicians,
Physician Consortium for Performance Improvement®. Pediatric acute
gastroenteritis physician performance measurement set. Chicago (IL):
American Medical Association (AMA); 2005 May. 7 p. \[1 reference\]

#### MEASURE AVAILABILITY

The individual measure, \"Acute Gastroenteritis: Education,\" is
published in the \"Clinical Performance Measures: Pediatric Acute
Gastroenteritis.\" This document and technical specifications are
available in Portable Document Format (PDF) from the American Medical
Association (AMA)-convened Physician Consortium for Performance
Improvement® Web site:
[www.physicianconsortium.org](http://www.physicianconsortium.org/).

For further information, please contact AMA staff by e-mail at
<cqi@ama-assn.org>.

#### NQMC STATUS

This NQMC summary was completed by ECRI Institute on December 6, 2006.
The information was verified by the measure developer on October 23,
2006.

#### COPYRIGHT STATEMENT

Physician Performance Measures (Measures) and related data
specifications, developed by the Physician Consortium for Performance
Improvement® (the Consortium), are intended to facilitate quality
improvement activities by physicians.

These Measures are intended to assist physicians in enhancing quality of
care. Measures are designed for use by any physician who manages the
care of a patient for a specific condition or for prevention. These
performance Measures are not clinical guidelines and do not establish a
standard of medical care. The Consortium has not tested its Measures for
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evaluation of its Measures.

Measures are subject to review and may be revised or rescinded at any
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Neither the Consortium nor its members shall be responsible for any use
of these Measures.

THE MEASURES ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.

© 2005 American Medical Association. All Rights Reserved.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008