National Quality Forum Board Approves AMDA Quality Measures on Dementia

March 11, 2013
Perry Gwen Meyers,

Columbia, MD – AMDA – Dedicated to Long Term Care Medicine (AMDA) is proud to announce the Board of the National Quality Forum (NQF), a nonprofit organization dedicated to improving the quality of health care nationwide, has approved two nursing home quality measures submitted by AMDA. The measures, “Persistent Indicators of Dementia without a Diagnosis – Long Stay” and “Persistent Indicators of Dementia without a Diagnosis – Short Stay,” are designed to be used by facilities as standards to set goals and pursue performance improvement for persons with dementia.  “The dementia measures approved by NQF and developed by AMDA undoubtedly will lead to improved care and quality of life for the most vulnerable of our patients,” said AMDA Past President Paul Katz, MD, CMD, who was a member of the measure development workgroup.

AMDA developed the two quality measures as part of its ongoing commitment to improving care for persons with dementia in nursing homes and to harmonize with existing Centers for Medicare & Medicaid (CMS) quality measures. Several elements of the CMS Minimum Data Set (MDS 3.0) capture and incorporate important information about a patient’s symptoms, including mental status (BIMS), depression (PHQ-9), and delirium (CAM) for the measures. To view the measures, click here

Up to 70% of nursing home patients carry a diagnosis of dementia. However, many health professionals believe that the disease remains under-diagnosed. Studies show that unrecognized dementia leads to poorly coordinated care, the overuse of aggressive care, and inappropriate and non-compassionate care for patients with the life-limiting illness. 

“Undiagnosed dementia is often the ‘silent bystander’ in residents throughout the long term care continuum. It changes [decisions about] what medications to utilize, prohibits the development of patient-centered care, drives up the cost of care, and endangers the person when transitions of care are necessary,” said AMDA Past President James Lett, II, MD, CMD, also a member of the measure development workgroup. He added, “The new AMDA measures are a first step in identification, then addressing a major enemy of good patient-centered care.”

Early and accurate dementia diagnosis is vital to optimizing care planning and to long term outcomes for persons with this illness, as well as their families. AMDA’s quality measures encourage recognition, comprehensive assessment, and appropriate treatment of cognition decline to generate several benefits.

Since cognitive decline can have multiple etiologies, prompt recognition of the problem can lead to identification of reversible or treatable medical or psychological conditions. Proper diagnosis of dementia can assist in the development of a comprehensive care plan that includes appropriate treatment, focuses on restoration and stability of intellectual function, and involves staff and family education about the disease and its prognosis.

Other members of the measure development workgroup included: Jurgis Karuza, PhD; William Smucker, MD, CMD; Eric Tangalos, MD, CMD; Christie Teigland, PhD; and Jacqueline Vance, RNC, BSN.

The NQF’s Consensus Standards Approval Committee recommended a total of five measures, including the two submitted by AMDA, for approval by the NQF board. All five were approved. Before final implementation, a 30-day appeals period will run through April 4, 2013.