Prevention Quality Indicators (PQIs)

At Penn Medicine, our goal is to provide the highest quality of care to our patients. We use various metrics to review and improve our performance, including Prevention Quality Indicators (PQIs), which play an important role in determining whether our healthcare services are effective.

The goal of PQIs is to help understand whether it is easy for patients to get the care they need outside of the hospital, and how good that care is within a community.

Quality and Accountability Performance Scorecard

Vizient’s Ambulatory Quality and Accountability (AQA) Performance Scorecard looks at how Penn Medicine’s performs in key areas, including access to care, care continuity, quality, efficiency, and equity. Penn Medicine is rated 4 out of 5 stars and is in the 74th percentile when compared to 63 academic health systems.

PQIs are among the quality measures Vizient uses to develop its AQA Performance Scorecard.

Data from the 2024 Vizient Ambulatory Quality and Accountability Performance Scorecard used by permission of Vizient, Inc. All rights reserved.

What are PQIs?

Prevention Quality Indicators are developed by the federal Agency for Healthcare Research and Quality. They analyze hospital data to find admissions that might have been avoided with better access to outpatient care. These measures give an idea of how well primary care and specialty services meet the needs of patients in the community. For example, PQIs track hospital admissions for conditions like heart failure and short-term complications of diabetes, which could often be prevented with timely care.

• Learn more about our heart failure admission rate
• Learn more about our diabetes short-term complications admission rate

Why are PQIs important?

PQIs help us understand how effectively we are managing certain conditions and illnesses.

PQIs measure how easy it is for people to get care outside the hospital and how well that care is working in a community. This helps identify areas where care might need to improve to keep people healthier and out of the hospital.

Penn Medicine’s approach to heart failure care

Penn Medicine’s heart failure program is dedicated to diagnosis and treatment of patients with all stages of heart failure. The program – one of the largest in the country – focuses on heart failure prevention, provides the most advanced therapies, and offers symptom relief to patients with complex needs.

The program is made up of experts in multiple specialties, including doctors, advanced practice providers, nurses, pharmacists, social workers, and more. It treats more than 3,800 patients each year, which is about 25 percent of all patients with heart failure at Penn Medicine. Other Penn patients with heart failure are treated by primary care and general cardiology.

The heart failure program is also dedicated to the West Philadelphia community, with all services available at the Hospital of the University of Pennsylvania – Cedar Avenue.

Penn Medicine’s heart failure program has received numerous awards, including the gold plus designation by the American Heart Association’s Get with The Guidelines Program and Joint Commission Advanced certification in heart failure and ventricular assist devices.

PQI: Heart failure admission rate

We use Vizient’s Ambulatory Quality and Accountability (AQA) Performance Scorecard to compare our performance against other academic medical centers across the country.

One of the PQIs we focus on is the heart failure admission rate. This metric compares our performance against the average rate of 63 academic health systems in our peer group.

Admissions for heart failure can be influenced by several factors, including:

• how sick a patient is
• a patient’s access to care
• a patient’s home environment
• a patient’s social support system
• and how well a patient follows their medical regimen, which includes medication, diet and exercise

Heart failure admission rate: How does Penn Medicine perform?

This scale shows how Penn Medicine’s heart failure admission rate compares with 63 other Complex Teaching Medical Centers included in Vizient Quality and Accountability scores. Instead of focusing on the numerical score, we present this on a scale of worse than, average, and better than. On the scale, "better than" means Penn Medicine performs better than the average outcomes of our peers, "average" means we have similar average outcomes to our peers, and "worse than" means we are below the average outcomes of our peers.

Heart failure admission rate

Data from the 2024 Vizient Ambulatory Quality and Accountability Performance Scorecard used by permission of Vizient, Inc. All rights reserved.

Our commitment to improving heart failure care

We strive for continuous improvement and are working to expand access to specialty care not only within our hospitals but also within the communities we serve. Here is just some of what we are doing to reach that goal:

• We present weekly lectures to community-based health care providers on topics related to caring for patients with heart failure.
• We provide ongoing training for community doctors through our continuing medical education (CME) program.
• We maintain an outpatient registry with the American Heart Association to support best practices for outpatient medical management of heart failure.
• We developed clinical pathways to manage hospitalized patients with heart failure and get them ready to return home. The pathways are designed to achieve guideline-directed medical therapy, educate patients and their caregivers, and make it easier to manage heart failure at home before being discharged from the hospital.

PQI: Diabetes short-term complications admission rate

We use Vizient’s Ambulatory Quality and Accountability (AQA) Performance Scorecard to compare our performance against 63 academic health systems in our peer group.

One of the PQIs we focus on is the diabetes short-term complications admission rate.

People with diabetes can experience serious complications that require hospitalization, including:

• when blood sugar gets dangerously high, called hyperglycemic emergencies
• diabetic ketoacidosis (DKA), when the body cannot use sugar properly and causes a buildup of acids in the blood
• hyperosmolar hyperglycemic state (HHS), when blood becomes very concentrated with sugar and other substances and the body does not have enough insulin to use the sugar properly
• or severe low blood sugar (hypoglycemia) that can cause a coma

The most common reasons for these emergencies are either being newly diagnosed with diabetes or not sticking to the prescribed treatment.

These issues can usually be improved by focusing on controlling blood sugar levels. Sometimes, these emergencies are caused by other health problems like infections or heart issues. The PQI for diabetes short-term admissions only includes cases where the diabetes-related problem is the main reason for the hospital stay.

Diabetes short-term complications admission rate: How does Penn Medicine perform?

This scale shows how Penn Medicine’s diabetes short-term complications admission rate compares with those of 63 other Complex Teaching Medical Centers included in Vizient Quality and Accountability scores. On the scale, "better than" means Penn Medicine performs better than the average outcomes of our peers, "average" means we have similar average outcomes to our peers, and "worse than" means we are below the average outcomes of our peers.

Diabetes short-term complications admission rate

Data from the 2024 Vizient Ambulatory Quality and Accountability Performance Scorecard used by permission of Vizient, Inc. All rights reserved.

Our commitment to improving diabetes care

Penn Medicine’s Diabetes Disease Team includes experts in primary care, endocrinology, pharmacy, care management, education, and the Center for Evidence-Based Practice.

The team is focused on improving "Poor Glycemic Control" in patients with diabetes. Here's what they're doing:

• Measuring and documenting how well patients are controlling their blood sugar using a test called Point of Care(POC) HbA1C.
• Using pharmacy and endocrinology consultations to improve treatment for those who aren't controlling their blood sugar well.
• Checking how well patients are sticking to their medication regimens.
• Offering education and support to help patients manage their diabetes better with resources from Penn Medicine and nutrition partners.
• Making it easy for diabetes patients to communicate with their healthcare team through a two-way texting program called DOTBot.

The team also did a pilot program with nutrition partner Simple Health from January 2021 to July 2022. The pilot’s goal was to help lower A1c in patients with diabetes. Through the program, 69% of patients reduced their HbA1C, with the average reduction of 1.9%.

Additional diabetes-care-related initiatives include:

• A pharmacy co-management program with eight primary care practices. Since 2023, primary care providers assess their patients who need observation or hospitalization. They review their patients’ medications and refer them to care management or pharmacy, as needed.
• Diabetes fellowships and consultations. Endocrinology provides e-consultations, an endocrinologist who is embedded in a primary care practice, and a one-year diabetes fellowship for primary care doctors.