Immunosuppressive therapy for myasthenic crisis

Measure Purpose: Rapidly initiate treatment for myasthenic crisis and thereby wean from mechanical ventilation, reduce likelihood of tracheostomy, and increase functional independence

The numerator: Patients with myasthenic crisis that are given immunosuppressive therapies (Plasmapheresis (PE) or intravenous immunoglobulin (IVIG))

is divided by

The denominator: Patients admitted to inpatient facility with a diagnosis of myasthenic crisis

Exclusions are removed from the denominator:

Patient has a previous history of severe systemic or anaphylactic response to IVIG
Patient is known to have anti-IgA antibodies with selective IgA deficiencies
Patient cannot tolerate central line placement
Patient is actively septic or hemodynamically unstable
Patient has an allergy to fresh frozen plasma or albumin
Patient has a heparin allergy that prevents receiving heparin as an anticoagulant during plasmapheresis
Patient with hypocalcemia
Patients who refuse

Key Phrases

Key phrases you should use to meet this measure include:

Patient prescribed IVIG
Patient prescribed intravenous immunoglobulin
Patient prescribed PE
Patient prescribed plasmapheresis
Patient prescribed immunosuppressive therapy

Measure Calculation Example

Dr. Martinez had 7 patients on her inpatient service in myasthenic crisis from January 1 to December 31 of the measurement year. This is the denominator. One patient has and allergy to fresh frozen plasma. This patient is removed from the denominator.

Of the six remaining patients, three of them received IVIG and one received PE.

Quality of care = 4/(7-1). Dr. Martinez has a score of 66% for this measure.