• Acceptable Types of Patient Care Practice Improvement Activities

    Additional examples can be found in the Primer on ABEM MOC APP PI Activities

    Core Measures

    o Acute Myocardial Infarction: aspirin on arrival

    o Acute Myocardial Infarction: ACE inhibitor or ARB given for LVSD

    o Acute Myocardial Infarction: Beta-blocker within 24 hours of arrival

    o Acute Myocardial Infarction: Fibrinolytic within 30 minutes of arrival

    o Acute Myocardial Infarction: PCI within 90 minutes of arrival

    o Pneumonia: Oxygenation assessment

    o Pneumonia: Blood cultures for ICU

    o Pneumonia: Blood culture before first antibiotic

    o Pneumonia: Antibiotic timing (within 4 hours; within 8 hours)

    PQRS Measures

    o Aspirin at arrival for acute myocardial infarction.

    o Stroke and stroke rehabilitation: deep vein thrombosis prophylaxis (DVT) for stroke or intracranial hemorrhage

    o 12-lead electrocardiogram (ECG) performed for non-traumatic chest pain

    o 12-lead electrocardiogram (ECG) performed for syncope

    o Community-acquired pneumonia (CAP): vital signs

    o Community-acquired pneumonia (CAP): assessment of oxygen saturation

    o Community-acquired pneumonia (CAP): assessment of mental status

    o Community-acquired pneumonia (CAP): empiric antibiotic

    o Prevention of catheter-related bloodstream infections (CRBSI): CVP insertion protocol

    Door to Balloon Time*

    Sepsis Pathways*

    Stroke Protocol/Pathways Activation*

    Asthma Pathways

    Throughput Time Measures 

    Door to Doctor Times

    Left without Being Seen 

    Unscheduled Return Visits

    Patient Call Back Program: Assessment of Clinical Care Given (not a satisfaction survey)

    Other types of patient care practice improvement activities are acceptable if they follow the four steps ABEM requires (see Patient Care Practice Improvement)

    * For important high-acuity, low-volume clinical issues, diplomates may measure fewer than ten of their own patients.