1. Timeliness of submitting the Report of Accident: percentage of claims for which Report of Accident was received within two business days of the first office visit. |
2. Two-way communication with employer: percentage of claims for which two-way communication between the provider and employer about the worker's return to work or work modification was completed at the first visit when the worker was off or expected to be off work. |
3. Activity prescription at each evaluation: percentage of workers for whom an activity prescription was discussed and documented in the chart at each evaluation (no more than once per week) when the worker was off or expected to be off work. |
4. Assessment for impediments to returning to work: percentage of workers on time loss who received an assessment or referral for an assessment of impediments to return to work after four weeks of work loss. |
5. Timeliness of access to care: percentage of workers seen within three business days of the worker's first contact with the provider. |
6. Probability of work relatedness adequately specified on the Report of Accident: percentage of claims for which the probability of work relatedness was adequately specified on the accident report. |
7. Continuity of care: percentage of workers who had not returned to work who were visited by a health care provider every two weeks for the first two months and at least once every two to four weeks following the worker's return to work. |
8. Condition-specific quality indicators: Twelve indicators were adopted for the three OHS target conditions, two for carpal tunnel syndrome (CTS), four for low back injury, and six for fractures. The following indicators are presented as examples: (1) nerve conduction studies to corroborate the presence or absence of CTS if a time loss of more than two weeks or surgery was being considered; (2) exam screens for the presence or absence of radiculopathy for patients with low back injuries (using recognized, reliable criteria) at the first visit; (3) the need for advanced imaging (low back injuries) to be adequately justified; and (4) a fracture's severity graded by documenting key elements at initial visit. The specific measure is the percentage of claims with specific conditions (CTS, low back injury, or extremity fracture) for which each indicator is documented in the medical record. |