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Emergency Care Capacity and Quality

CBE ID
4625e
Endorsement Status
E&M Committee Rationale/Justification

When the measure returns for maintenance (3 years), the measure developer should have:

  • Explored any unintended consequences to patients and providers (burden) by engaging with the patient community and accountable entities (e.g., qualitative assessments, empirical analyses); and
  • Explored the component measures to identify and address where challenges may persist, including engaging accountable entities. 
1.0 New or Maintenance
1.1 Measure Structure
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Fall 2027
1.6 Measure Description

This intermediate outcome eCQM captures the proportion of visits for patients of all ages that experience emergency care access barriers during a one-year performance period.

Measure Specs
General Information
1.7 Measure Type
1.7 Composite Measure
No
1.3 Electronic Clinical Quality Measure (eCQM)
1.8 Level of Analysis
1.9 Care Setting
1.10 Measure Rationale

The Emergency Care Capacity and Quality (ECCQ) Electronic Clinical Quality Measure (eCQM) is a de novo intermediate clinical outcome measure that captures variation in the capacity and quality of emergency care to support hospital quality improvement and improve patient outcomes. The score will report the proportion of quality gaps in access at the facility level (emergency department) for intended use in an accountability program through which it may be publicly reported (i.e., the Hospital Outpatient Quality Reporting (HOQR) Program and the Rural Emergency Hospital Quality Reporting (REHQR) Program). Limitations in capacity and quality of emergency care have been shown to be associated with harm, such as increases in mortality, delays in care, preventable errors, poor patient experience and staff burnout.

The measure aims to reduce patient harm and improve outcomes for patients requiring emergency care in an emergency department (ED). Emergency care capacity is inclusive of several concepts pertaining to boarding and crowding in an ED. This measure aligns with incentives to promote improved care both in EDs and the broader health system to help identify where patients do not receive equitable access to emergency care.

The measure captures established outcome metrics already in use that quantify capacity and access of care in an ED, such as ED arrival and departure times. The ECCQ eCQM aims to positively impact millions of patients who seek treatment in the ED and help address long standing disparities in emergency care, including for patients with mental health diagnoses. Additional disparities in ED care are well documented for patients of older age, by race and ethnicity, primary language, and insurance status; such documented disparities include significantly longer ED wait times, higher left without being seen rates, longer boarding times, and longer total length of stay in the ED. 

1.20 Types of Data Sources
1.25 Data Source Details

Since ECCQ is an eCQM, it is specified in a standard electronic format and uses data electronically extracted from electronic health records (EHRs). Facilities are required to electronically report eCQMs using EHR data. All data elements in the measure are defined fields in electronic sources.