CARE GUIDELINES FROM MCG
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1 CARE GUIDELINES FROM MCG Evidence-based guidelines from MCG span the continuum of care, supporting clinical decisions and care planning, easing transitions between care settings, and facilitating conversations between providers and payors.
2 BY THE NUMBERS References reviewed and ranked for the current edition: 118,982 References cited in the current edition: 25,789 Number of these that are new: 6,606 Number that are annotated: 11,604 Diagnosis-specific acute care Optimal Recovery Guidelines: 292 Unique citations in acute care Optimal Recovery Guidelines: 7,009 Average references cited per acute care Optimal Recovery Guideline: 24 Total ambulatory care guidelines (including guidelines for referral management): 692 Total care management tools: 19 Total patient handouts: 868 Number of hospitals, physician groups, health plans, and other healthcare management organizations that license the care guidelines: 2,200 Percentage of commercially insured Americans whose care is supported by the care guidelines: 70 *Guideline-related figures here reflect the 18th edition
3 THE FIRST WORD IN EFFECTIVE CARE Care guidelines should support the clinical judgment of highly qualified physicians, not replace it. The best guidelines distill the latest research, helping you hone your knowledge of a condition or procedure. The best guidelines foster evidence-based conversation between providers and payors, conversation that drives the delivery of appropriate care at the right time and in the right setting. The best guidelines improve outcomes by educating patients and engaging them as partners in their treatment.
4 TRANSPARENT, COMPREHENSIVE, AND ACTIONABLE EVIDENCE Care guidelines from MCG support care decisions by providing ready access to the most complete, thoroughly reviewed clinical evidence in the industry either online or through one of our interactive software solutions. Inpatient guidelines include contextual references and footnotes, annotated bibliographies, evidence grades of key sources, and a list of supporting references and abstracts pertinent to the given diagnosis. Our clinical editors develop the care guidelines in strict accordance with the principles of evidencebased medicine. Relevant randomized controlled trials, meta-analyses, and systematic reviews published in peer-reviewed literature have primacy, followed by observational studies and information obtained from textbooks and specialty society guidelines. When published studies or information is scant or nonexistent, MCG recognizes the value of frontline experience and incorporates data from unpublished sources, including large database analysis, quality improvement projects, community experience, and expert opinion. Sample of Acute Care Guidelines in the 18th Edition Total Unique References* Guideline Number of References Heart Failure 78 Pneumonia, Community Acquired 73 Myocardial Infarction 72 Chronic Obstructive Pulmonary Disease (COPD) 71 Hip Arthroplasty 51 Lumbar Fusion 57 Asthma 50 Diabetes 45 Transient Ischemic Attack (TIA) 44 Syncope 45 *Care guidelines integrate national quality measures and accreditation requirements
5 Evidence Grades Evidence Grade Description 1 Meta-analyses Randomized controlled trials with meta-analysis Randomized controlled trials Systematic reviews 2 Observational studies, such as: Cohort studies with statistical adjustment for potential confounders Cohort studies without adjustment Case series with historical or literature controls Uncontrolled case series Published guidelines Statements in published articles or textbooks 3 Unpublished data, such as: Large database analyses Written protocols or outcomes reports from large practices Expert practitioner reports SUPERIOR DEPTH AND BREADTH OF CONTENT Unlike body system criteria, inpatient guidelines from MCG are designed to guide care toward optimal recovery using disease- and procedure-specific best practices and length of stay benchmarks. MCG offers the most thorough coverage of acute inpatient conditions and procedures on the market 292 guidelines in all, including 238 adult and 54 pediatric. MCG also offers 29 distinct General Recovery Care guidelines to support the care management of complex cases or when no acute care guideline seems applicable. General Recovery Guidelines are organized by problem area and body system and feature benchmark patient care and recovery data. Licensed by CMS vendors and 8 of the 10 largest commercial health plans in the United States, care guidelines from MCG cover the entire continuum of care within and beyond hospital walls: Ambulatory care Observation care Acute inpatient care Intensive care Neonatal intensive care Long-term acute hospital care Inpatient rehabilitation care Sub-acute facility care Skilled nursing facility care Home care Behavioral health care in multiple settings
6 SUPPORT FOR CARE MANAGEMENT AND EXTENDED STAY REVIEW Every Optimal Recovery Care guideline features an Optimal Recovery Course, presented in a care pathway format, which specifies the level of care, patient activity, clinical status, and interventions appropriate for each day of a patient s stay in the hospital. Recovery milestones provide clear markers of a patient s progress toward discharge. The ability to identify variation from optimal progression the progress made by an optimally responsive patient receiving optimal care gives the clinician the opportunity to review the cause of the variance to determine whether it was medically necessary or potentially avoidable. In addition to describing optimal care and recovery, the care guidelines also address patients who need to stay in the hospital beyond the goal length of stay as well as those who develop complications or exacerbations of comorbid conditions. Extended Stay guidance in each acute care guideline is diagnosis-specific and includes references to supporting evidence. GOAL LENGTH OF STAY Every diagnosis-based acute care guideline identifies a Goal Length of Stay (GLOS), which is the length of stay possible for a substantial number of patients for a particular diagnosis given optimal recovery, decision-making, and health system design and performance. GLOS data can help identify and track performance against attainable realistic length of stay goals. BENCHMARKING DATA The Benchmarks and Data Website, available through a link on the care guidelines homepage, provides statistical companions to these and other data sets, including readmission rate benchmarks and geometric lengths of stay by region. It also includes healthcare utilization models for inpatient, home care, recovery facility care, and behavioral health services for both commercial and Medicare patients. IMPLEMENTATION AND TRAINING INCLUDED IN LICENSE An MCG license includes initial and annual training assessments, custom training plans, guideline adoption assistance, on-demand training, and regular webinars for beginning and advanced users. Guideline Adoption Advisors provide on-site assistance with implementation; the only cost of this service are the travel expenses of our staff. The evidence we all go back to it, all of us, whether we re case managers, nurses, or social workers. The world of healthcare is evidence-based. Director of Case Management
7 Definition Supporting Reference Annotation Evidence Grade Footnote Readmission Risk Assessment Recovery Milestone
8 For more information on the care guidelines, licensing, or training, please call us at or visit us at MCG 901 Fifth Avenue, Suite 2000 Seattle, WA ABOUT MCG MCG, now part of the Hearst Health network, independently develops and produces evidence-based clinical guidelines and software used by more than 2,200 clients, including 1,300 hospitals and eight of the ten largest U.S. health plans. Updated annually by an experienced team of clinicians, the care guidelines support the care management of a majority of Americans. For more information, visit MCG is part of the Hearst Health network, which also includes FDB (First Databank), Zynx Health, Homecare Homebase, and Hearst Health International. The mission of the Hearst Health network is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person s health journey. Each year in the U.S., care guidance from the Hearst Health network reaches 84 percent of discharged patients, 174 million insured individuals, 35 million home health visits, and 4 billion prescriptions. Extensions of the Hearst Health network include Hearst Health Ventures and the Hearst Health Innovation Lab.
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