MedWire News: The American College of Cardiology (ACC) and the American Heart Association (AHA) have published a new set of performance measures covering key features of the treatment of patients with ST-elevation and non-ST-elevation myocardial infarction (STEMI/NSTEMI).
The report is an update of the 2006 edition and defines measures of important healthcare processes, such as specific treatments for STEMI/NSTEMI, as well as measures of care structures, outcomes, and efficiency.
The main aim of the document is to improve the quality of clinical care, say the authors, although the measures may also be used for external review or public reporting of provider performance. All metrics are categorized as either performance measures or test measures.
“By facilitating measurements of cardiovascular healthcare quality, ACC/AHA performance measurement sets may serve as vehicles to accelerate appropriate translation of scientific evidence into clinical practice,” write Harlan Krumholz (Yale University, New Haven, Connecticut) and fellow authors.
“These documents are intended to provide practitioners and institutions that deliver care with tools to measure the quality of their care and to identify opportunities for improvement.”
A new aspect of the 2008 document is the deletion of “beta-blockers on arrival in hospital” as a metric. The rationale for this change was the “increased complexity of decision-making and controversy about the magnitude of net benefit,” according to the authors.
The revised document now specifies “statin therapy at discharge” as opposed to the previous, broader category of “lipid-lowering therapy.” It also removes the requirement that low-density lipoprotein cholesterol is >100 mg/dl before such therapy is initiated.
The report also introduces several new performance measures, including metrics dealing with the evaluation of left ventricular systolic function, the timeliness of reperfusion therapy in patients transferred for percutaneous coronary intervention, and referral to cardiac rehabilitation programs.
The ACC/AHA report was developed in collaboration with the American Academy of Family Physicians and the American College of Emergency Physicians, and is endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, Society for Cardiovascular Angiography and Interventions, and Society of Hospital Medicine.
It is co-published in the Journal of the American College of Cardiology and the journal Circulation.
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