Increasing Quality of Life for Neurology Inpatients is Goal of Newly Established Metrics

By Suzanne Leigh

To improve the quality of life for neurology inpatients, a panel of experts, led by UC San Francisco neurologist S. Andrew Josephson, MD, has released quality measurements.

 S. Andrew Josephson
S. Andrew Josephson, MD

“Increased scrutiny on quality and safety in hospitals nationwide has led to the development of multiple metrics for inpatients across a variety of specialties [but] few quality metrics exist specifically for disorders of the nervous system,” said Josephson, chair of the UCSF Department of Neurology, in an article he authored in the journal Neurology, published on July 21, 2017.

Quality measurements are defined as a “diagnostic or treatment activity that should be performed in the majority of patients” and can be measured using objective criteria.

While there are “thousands of guidelines published” for treating patients in the hospital, most physicians are unaware of these and do not track their adherence, according to Josephson. To address this, Josephson, together with 30 or so national experts assembled by the American Academy of Neurology and two other national societies, have established these quality measurements.

Josephson and other members of the Inpatient and Emergency Neurology Quality Measurement Set Work Group identified 12 areas in which quality metrics will be used to drive improvements in patient care. These run the gamut from the percentage of neurology inpatients in which brain death was diagnosed using proper procedures, to the percentage of patients suspected of having meningitis who were given a steroid to reduce inflammation at the same time as they were given the first dose of antibiotics.

“Rather than allow insurers or non-neurologists to define quality across neurologic conditions, this effort aims to garner neurologic expertise by defining measures that were supported by evidence and were relevant to the practicing neurologist.”

The metrics have since been distributed to every neurologist in the nation.

“These metrics have the potential to launch a new era in neurologic inpatient medicine, where attention is carefully paid to practicing consistency of evidence-based care,” said Josephson, who is also professor of neurology, and director and founder of the UCSF Neurohospitalist Program. “This effort will enable physicians and health care systems to work together, reporting rates of adherence to quality metrics that can be easily accessible to other providers, payors and the public at large, driving better care for our patients.”