This post was authored by John Rumsfeld, MD, FACC, chief science officer and chair of the NCDR.

The ACC in Touch Blog has spent the last two months exploring Appropriate Use Criteria (AUC), including what the criteria are; how to implement AUC in practice; and what AUC might look like in the future. This week’s post is focused on the National Cardiovascular Data Registry (NCDR®) and its ties to AUC. What might those ties be, you ask?

Well, the NCDR began in 1997 as a quality improvement initiative of the ACC to help hospitals and clinicians measure and benchmark the quality of their care. Today, the NCDR has six national hospital-based programs and one ambulatory care program (PINNACLE).  While much of the data collected in NCDR maps to the ACC/AHA clinical practice guideline recommendations, NCDR is committed to capturing data for quality metrics from the suite of ACC science documents, including performance measures and AUC.

The NCDR is involved with AUC in several ways. The CathPCI Registry already has data mapped to the coronary revascularization AUC.  Hospital participants receive quarterly CathPCI Registry outcomes reports that now include AUC for coronary revascularization metrics. The new ‘point of care’ CathPCI tool supports assessment of individual cases with regard to AUC category. The CathPCI AUC metrics are intended to support local quality improvement efforts for use by hospitals to compare themselves to a national rate, evaluate individual cases with regard to appropriateness, and determine if a quality improvement process is needed. Importantly, by ‘operationalizing’ the collection of data to measure AUC through NCDR, important feedback has been provided by hospitals and ACC members toward improvement of the AUC. The NCDR data elements will be updated with each version of the AUC that is released.

Currently, AUC on implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) are under development. Once finalized, AUC metrics will be created for the ICD Registry reports as well.

As additional AUC are created by ACC and partnering organizations, the NCDR will strive to capture relevant data – in the inpatient and ambulatory care settings – to support measurement and benchmarking for hospitals and practices. Moreover, the NCDR programs are evolving to integration with clinical workflow. As point of care tools become available to support clinical decisions, including appropriateness, NCDR will incorporate them into its programs. NCDR is committed to measuring and improving quality of care and patient outcomes, and as AUC are part of the Science and Quality documents of the ACC and its partnering organizations, NCDR is committed to the valid measurement and feedback of AUC.

For more information about NCDR, visit www.ncdr.com. For more information about AUC, visit www.CardioSource.org/AppropriateUse.

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