Please see information on the Perinatal Behavioral Health Report under the “Behavioral Health” section.
Reproductive Health
Hysterectomy
Guideline title: Hysterectomy Report and Guidelines
Publication Status: Active
Date of publication: 2018
Date of last evidence search: 2018
Scope: Assessment and medical management; uterine sparing procedures; surgical procedure; follow-up care; enhanced recovery after surgery protocol; use of a minimally invasive approach.
Methods: Current guidelines and literature review and expert consensus
Description: The workgroup’s goal is to promote appropriate use of hysterectomy, including pre-surgical counseling and evaluation, while recognizing individual variation based on clinical opinion and patient preference. Workgroup members developed the guidelines to encourage clinicians to review guidelines with patients prior to hysterectomy to reduce unnecessary or inappropriate hysterectomies.
In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development process. A framework for evaluation has been created and recommended metrics have been identified by audience (below).
Ambulatory Care
Note: Metric 1-3 are not endorsed, should be tested, who is the steward
Metric 1 – Screening for Abnormal Blood Glucose – Percentage of patients aged 40 years and older with a BMI ≥ 25 who are seen for at least two office visits or at least one preventive visit during the 12-month period who were screened for abnormal blood glucose at least once in the last 3 years.
Metric 2 – Intervention for Prediabetes – Percentage of patients aged 18 years and older with identified abnormal lab result in the range of prediabetes during the 12-month measurement period who were provided an intervention.
Metric 3 – Retesting of Abnormal Blood Glucose in Patients with Prediabetes – Percentage of patients aged 18 years and older who had an abnormal fasting plasma glucose, oral glucose tolerance test, or hemoglobin A1c result in the range of
prediabetes in the previous year who have a blood glucose test performed in the one-year measurement period.
Metric 4 – Eye Exam for Patients with Diabetes (EED) (HEDIS) NQF# 0055, by race, ethnicity/language, insurance status
Metric 5 – Kidney Health Evaluation for Patients with Diabetes (KED) (HEDIS), by race, ethnicity/language, insurance status
Metric 6 – Blood Pressure Control for Patients With Diabetes (BPD) (HEDIS) NQF# 0061, by race, ethnicity/language, insurance status
Metric 7 – Hemoglobin A1c Control for Patients with Diabetes (HBD) (HEDIS) NQF# 0059, by race, ethnicity/language, select comorbities, insurance status
Metric 8 – Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E) (Uses Electronic Data System (ECDS) reporting)
Hospitals
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Dentists
Metric 1 – Percent of patients who have been screened for a primary car provider visit in the last 6 months
Dental Plans
Percent of members who have been screened for a primary care provider visit in the last six months
Dental Plans
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Schools
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Health Plans
Metric 1 – Screening for Abnormal Blood Glucose – Percentage of patients aged 40 years and older with a BMI ≥ 25 who are seen for at least two office visits or at least one preventive visit during the 12-month period who were screened for abnormal blood glucose at least once in the last 3 years.
Metric 2 – Intervention for Prediabetes – Percentage of patients aged 18 years and older with identified abnormal lab result in the range of prediabetes during the 12-month measurement period who were provided an intervention.
Metric 3 – Retesting of Abnormal Blood Glucose in Patients with Prediabetes – Percentage of patients aged 18 years and older who had an abnormal fasting plasma glucose, oral glucose tolerance test, or hemoglobin A1c result in the range of
prediabetes in the previous year who have a blood glucose test performed in the one-year measurement period.
Washington State Health Care Authority
Metric 1 – Screening for Abnormal Blood Glucose – Percentage of patients aged 40 years and older with a BMI ≥ 25 who are seen for at least two office visits or at least one preventive visit during the 12-month period who were screened for abnormal blood glucose at least once in the last 3 years.
Metric 2 – Intervention for Prediabetes – Percentage of patients aged 18 years and older with identified abnormal lab result in the range of prediabetes during the 12-month measurement period who were provided an intervention.
Metric 3 – Retesting of Abnormal Blood Glucose in Patients with Prediabetes – Percentage of patients aged 18 years and older who had an abnormal fasting plasma glucose, oral glucose tolerance test, or hemoglobin A1c result in the range of
prediabetes in the previous year who have a blood glucose test performed in the one-year measurement period
Metric 4 – Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E) (Uses Electronic Data System (ECDS) reporting)
Metric 5 – Adult Immunization Status (AIS-E)
Metric 6 – Kidney Health Evaluation for Patients With Diabetes (KED)
Metric 7 – Eye Exam for Patients with Diabetes (EED) (HEDIS) NQF# 0055, by race, ethnicity/language, insurance status
Metric 8 – Blood Pressure Control for Patients With Diabetes (BPD) (HEDIS) NQF# 0061, by race, ethnicity/language, insurance status
Health Care Purchasers
Health care purchasers should consider including or requiring tracking of all recommended metrics on the Washington State Health Care Authority tab in this section.
Employers should consider developing measures for and tracking the following:
- Days of work missed due to complications from Diabetes
- Number of employees receiving evidence-based care for diabetes
- Number of employees with diabetes who have same day access to care
- Rapid return to function after diabetes complications
- Patient experiences with diabetes care
- Total cost of care for patients with diabetes
Obstetrics Care
Guideline title: Obstetrics Care Report and Guideline
Publication Status: Needs minor revisions – to be scheduled
Date of publication: August 2012
Date of last evidence search: 2012
Scope: Elective deliveries, Elective inductions of labor, Primary c-sections
Methods: Current guidelines and literature review and expert consensus
Description: This report aims to to accelerate quality improvement in three areas of OB, which, in turn, will improve the safety, quality, and affordability of patient care for mothers and infants, and decrease costs for the entire community.
In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development process. A framework for evaluation has been created and recommended metrics have been identified by audience (below).
Delivery Sites and Health Systems
Health System Evaluation Score Card
Health Plans
Health Plan Evaluation Score Card
Washington State Health Care Authority
Metric 1 – Screening for Abnormal Blood Glucose – Percentage of patients aged 40 years and older with a BMI ≥ 25 who are seen for at least two office visits or at least one preventive visit during the 12-month period who were screened for abnormal blood glucose at least once in the last 3 years.
Metric 2 – Intervention for Prediabetes – Percentage of patients aged 18 years and older with identified abnormal lab result in the range of prediabetes during the 12-month measurement period who were provided an intervention.
Metric 3 – Retesting of Abnormal Blood Glucose in Patients with Prediabetes – Percentage of patients aged 18 years and older who had an abnormal fasting plasma glucose, oral glucose tolerance test, or hemoglobin A1c result in the range of
prediabetes in the previous year who have a blood glucose test performed in the one-year measurement period
Metric 4 – Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS-E) (Uses Electronic Data System (ECDS) reporting)
Metric 5 – Adult Immunization Status (AIS-E)
Metric 6 – Kidney Health Evaluation for Patients With Diabetes (KED)
Metric 7 – Eye Exam for Patients with Diabetes (EED) (HEDIS) NQF# 0055, by race, ethnicity/language, insurance status
Metric 8 – Blood Pressure Control for Patients With Diabetes (BPD) (HEDIS) NQF# 0061, by race, ethnicity/language, insurance status
Health Care Purchasers
Health care purchasers should consider including or requiring tracking of all recommended metrics on the Washington State Health Care Authority tab in this section.
Employers should consider developing measures for and tracking the following:
- Days of work missed due to complications from Diabetes
- Number of employees receiving evidence-based care for diabetes
- Number of employees with diabetes who have same day access to care
- Rapid return to function after diabetes complications
- Patient experiences with diabetes care
- Total cost of care for patients with diabetes
Perinatal Bundled Payment Model
Guideline title: Perinatal Bundled Payment Model Report and Guidelines
Publication Status: Needs minor revisions – to be secheduled
Date of publication: First published 2019, Revision in 2021
Date of last evidence search: 2021
Scope: This report presents a payment model that includes prenatal care, labor and delivery, postpartum care, and pediatric care along with clinical components for internal quality tracking and performance metrics.
Methods: Current guidelines and literature review and expert consensus
Description: The work group developed a clinical pathway supported by an episode-based payment building on existing perinatal work within Washington State prioritizing health equity, high-quality, and evidence based perinatal and pediatric care.
Resources and Tools
Appendix D: Episode and Perinatal Guideline Systematic Review Search Results
Appendix F: Included Services and Coding
Appendix H: Behavioral Health Treatment
Appendix I: Opioid Use Disorder Treatment
Appendix J: Pediatric – Obstetrics Information Exchange
Appendix K: Postpartum 4-12 Per-Member-Per-Month
California Maternal Quality Care Collaborative Cardiovascular Disease
in Pregnancy and Postpartum Toolkit
Washington State Perinatal Collaborative (WSPC)
ACOG Optimizing Postpartum Care
AAP Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice
Purchaser Business Group on Health
In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development process. A framework for evaluation has been created and recommended metrics have been identified by audience (below).
Delivery Sites and Health Systems
Health System Evaluation Score Card
Health Plans
Health Plan Evaluation Score Card
Washington State Health Care Authority
Health Care Purchasers
Reproductive and Sexual Health
Guideline title: Reproductive and Sexual Health Report and Guidelines
Publication Status: Active
Date of publication: 2020
Date of last evidence search: 2020
Scope: Cultural humility; access; person-centered care; appropriate care
Methods: Current guidelines and literature review and expert consensus
Description: These guidelines aim to improve quality, equity, and cultural appropriateness of reproductive and sexual healthcare services across the lifespan in Washington State. The workgroup has expanded on the populations identified in Senate Bill 5602 (2019) to focus on improvement of clinical services for those who are Black, indigenous, people of color, immigrants or refugees, have experienced violence including human trafficking, people with disabilities, and Lesbian, Gay, Bisexual, Transgender, and/or Questioning or Queer (LGBTQ+).
In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development process. A framework for evaluation has been created and recommended metrics have been identified by audience (below).
Delivery Sites and Health Systems
Health System Evaluation Score Card
Health Plans
Health Plan Evaluation Score Card
Washington State Health Care Authority
Health Care Purchasers
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