Quality of Care in Cardiology
- López-Sendón JL, González-Juanatey JR, Pinto F, et al.
- Quality Markers in Cardiology: Measures of Outcomes and Clinical Practice—a Perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery. Eur Heart J 2015;Oct 21:[Epub ahead of print].
The following are 10 points to remember about quality markers in cardiology, as articulated by a task force convened by the Spanish Society of Cardiology and the Spanish Society of Thoracic and Cardiovascular Surgery:
- Clinical outcomes are the primary measurement of quality of care in cardiology.
- The Task Force recommends the use of all-cause mortality during the index hospitalization (versus different causes of mortality, which would need adjudication).
- Mean mortality rates have to be adjusted for case complexity rate to be fair for centers for a large number of acute coronary syndrome patients in shock or after cardiopulmonary resuscitation.
- Comparisons should be made only between similar hospitals and in selected, well-defined, high-risk-specific populations.
- Extreme high-risk and low-prevalence groups of patients should be excluded.
- The Task Force suggests performance measures in clinical cardiology, cardiac imaging, acute cardiac care, interventional cardiology, electrophysiology and complex arrhythmia, heart failure, cardiac rehabilitation, and cardiac surgery.
- A Heart Team approach is advocated for all cases of heart surgery.
- The Task Force suggests identification of quality metrics for outpatient clinical practice as an opportunity for improvement.
- The Task Force suggests that standardization of data (e.g., data capture and availability) is an unmet need.
- The authors opine, “Registries and databases currently used for benchmarking may not have the appropriate quality. Audited, dedicated, prospective mandatory reports would be arguably the best way of capturing simple but essential/core information.”
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