To guide national quality improvement efforts, HCFA collected information about the care Medicare beneficiaries received in 1997- 99 based on 24 clinical indicators in the six targeted disease areas. Local PROs have the solid relationships with physicians, hospitals and other caregivers needed to make meaningful changes in how care is delivered. This approach works. To increase the rapid first administration of antibiotics help prevent an estimated 700 deaths annually of Medicare beneficiaries with pneumonia. To increase the appropriate use of blood thinners for people at risk of having a stroke prevent an estimated 1,285 strokes annually.
PROs measure how often care is delivered in accordance with the quality indicators.
When there is a gap between the accepted standard of care and the actual care provided, PROs work with physicians and other caregivers to examine their practices and change how they provide care. PROs provide suggestions based on successful improvement projects in other hospitals and clinics consistent with the medical literature. They then remeasure the indicators to find out if the quality improvement intervention succeeded. The HCFA data show that there are gaps in care for older Americans. For example, medical experts agree that many patients whose hearts beat irregularly due to a condition called atrial fibrillation, and who are, therefore, at risk of having a stroke could benefit from a blood-thinning medication called warfarin.