For patients who screened positive for dyspnoea, the percent who receive medication or non-medication treatment within 24 hours of screening.

Patients who screened positive for dyspnoea who received treatment within 24 hours of screening. Treatment is administered if within 24 hours of the positive screen for dyspnoea, medical treatment plan, orders or pharmacy records show inhaled medications, steroids, diuretics, or non-medication strategies such as oxygen and energy conservation. Treatment may also include benzodiazepine or opioid if clearly prescribed for dyspnoea.

Patients enrolled in hospice for 7 or more days OR patients receiving palliative care who report dyspnoea when dyspnoea screening is done on the admission evaluation / initial encounter.

Denominator Exclusions: Palliative care patients with length of stay < 1 day or hospice patients with length of stay < 7 days, patients who were not screened for dyspnoea, and/or patients with a negative screening. Calculations required to perform denominator exclusions: Discharge date – admission date = 1 or hospice patients with discharge date – admission date = 7.

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Data Source: Electronic Clinical Data. Hospice and palliative care: consecutive sample of equal numbers of admissions + decedents beginning with randomly selected date; minimum sample size 100. Data collection using a structured chart abstraction tool and operational definition.

The Level of Analysis is performed at the Clinician (Group/Practice) and Facility levels.

Indicator development: Anna P. Schenck, Franziska S. Rokoske, Danielle D. Durham, John G. Cagle, and Laura C. Hanson. The PEACE Project: Identification of Quality Measures for Hospice and Palliative Care.Journal of Palliative Medicine.Dec 2010.1451-1459.http://doi.org/10.1089/jpm.2010.0238 Indicator feasbility/testing: Hanson LC, Rowe C, Wessell K, et al. Measuring palliative care quality for seriously ill hospitalized patients. J Palliat Med 2012;15(7):798-804. PEACE website: www.med.unc.edu/pcare/about-palliative-care/resources/peace-quality-measures/

Full specifications were taken from NQF documentation available here: www.med.unc.edu/pcare/wp-content/uploads/sites/503/2017/11/nqf-dyspnea-treatment.pdf Unable to locate from PEACE program literature. Limited specification details available in Table 2 of Hanson LC, Rowe C, Wessell K, et al. Measuring palliative care quality for seriously ill hospitalized patients. J Palliat Med 2012;15(7):798-804. PEACE website: www.med.unc.edu/pcare/about-palliative-care/resources/peace-quality-measures/

Linked to: NQF measure #1638 (endorsement status for this indicator was removed on 17 November 2021) and is paired with #1640 Hospice and Palliative Care - Dyspnea Screening and Dyspnea Treatment. This measure is part of a composite measure: Paired with Hospice and Palliative Care – Dyspnea Screening.