NQMC Update Service: March 10, 2014 ► RAND Corporation

NQMC Update Service: March 10, 2014

March 10, 2014

RAND Corporation

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom a
  provider documented a visit between the operating surgeon (or member of
  the operating team) and patient within 1 month prior to the date of the
  surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom a
  provider documented the presence of, absence of, or changes to allergies
  or medication intolerances within 1 month prior to surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom a
  provider documented the presence of, absence of, or changes to medical
  co-morbidities within 1 month prior to surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom a
  provider documented the presence of, absence of, or changes to
  medications within 1 month prior to surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom a
  provider documented the presence of, absence of, or changes to past
  surgical history within 1 month prior to surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom a
  provider documented the presence of, absence of, or changes to symptoms
  affecting at least two different organ systems within 1 month prior to
  surgery.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom a transverse carpal ligament repair was not performed.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom CTS
  surgery was performed after the patient was evaluated with one or more
  of the specified criteria.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom either a
  flexor tenosynovectomy was not performed or proliferative
  tenosynovitis, or a condition associated with severe proliferative
  tenosynovitis, was documented in the operative report or in the medical
  record during the six months before surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom either a
  superficial epineurotomy was not performed or a specific injury or
  scarring of the median nerve was documented in the operative report or
  in the medical record during the six months before surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom either
  internal neurolysis was not performed or a specific injury or scarring
  of the median nerve was documented in the operative report or in the
  medical record during the six months before surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom the
  medical record documents that a medical provider who treats
  musculoskeletal disorders or a physical/occupational/hand therapist
  evaluated the hand during a postoperative clinic visit.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom the
  medical record documents that the surgeon or a member of the operating
  team evaluated the current (i.e., postoperative) carpal-tunnel-related
  symptoms at the first postoperative visit.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom the
  operating surgeon (or member of the surgical team) documents all three
  specified criteria in the medical record during the 18 months prior to
  carpal tunnel surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom the
  operating surgeon (or member of the surgical team) documents the
  presence or absence of a history of previous treatments for CTS during
  the 18 months prior to carpal tunnel surgery.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom the
  surgeon used a primary open rather than endoscopic approach.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom there
  is documentation in the operative report describing the location of the
  incision(s) in the area of the wrist and the incision was in a location
  that avoids the injury to the palmar cutaneous branch of the median
  nerve.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom there
  is documentation in the operative report that the deep surface of the
  transverse carpal ligament was identified prior to transection.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients for whom there
  is documentation in the operative report that the transverse carpal
  ligament in the wrist was transected.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients who are
  re-examined by the operating surgeon within eight weeks of the visit at
  which the lack of improvement in CTS-related symptoms was first
  documented.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients who had a second
  visit, specifically with the surgeon or member of the operating team,
  within two weeks of the postoperative visit at which finger stiffness
  was first documented.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients who were
  referred for physical/occupational/hand therapy within one month of the
  visit during which finger stiffness was first documented.

• Carpal
  tunnel syndrome (CTS): percentage of eligible patients who, within one
  year after carpal tunnel surgery and no substantial improvement in
  CTS-related symptoms, underwent a diagnostic test of the study hand,
  were evaluated by a different specialist who treats musculoskeletal
  disorders, or refused further evaluation.

• Carpal
  tunnel syndrome (CTS): percentage of patients with CTS who were
  consented for an endoscopic carpal tunnel release surgery during part of
  the study period for whom the consent included a provision for an open
  approach.