2023 Clinical Performance Measures for Coronary Revascularization: Key Points

Authors:
Dehmer GJ, Grines CL, Bakaeen FG, et al.
Citation:
2023 AHA/ACC Clinical Performance and Quality Measures for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Performance Measures. J Am Coll Cardiol 2023;Jul 27:[Epub ahead of print].

The following are key points to remember from a 2023 American Heart Association (AHA)/American College of Cardiology (ACC) Clinical Performance and Quality Measures for Coronary Artery Revascularization document:

  1. The AHA/ACC performance measurement sets serve as vehicles to accelerate translation of scientific evidence into clinical practice and are intended to provide practitioners and institutions that deliver cardiovascular services with tools to measure the quality of care provided and identify opportunities for improvement.
  2. With the large number of patients undergoing revascularization procedures annually, initiatives that improve the quality of care of patients undergoing coronary artery revascularization procedures are needed. This document describes performance measures for coronary revascularization that are appropriate for public reporting or pay-for-performance programs.
  3. This is the first joint AHA/ACC document developing measures related to coronary artery revascularization. Most performance measures were developed from the “2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization” and are selected from the strongest recommendations (Class 1 or 3). This set includes 15 performance measures, 5 quality measures, and 2 structural measures.
  4. Quality measures are included in this document as metrics that may be useful for local quality improvement programs but are not yet appropriate for public reporting or pay-for-performance programs.
  5. Structural measures are useful to assess infrastructure, systems, and processes of care. Two such structural measures were developed. One structural measure is related to the presence and function of the Heart Team and the other structural measure is related to registry participation.
  6. For all measures, if the clinician determines the guideline-recommended care is inappropriate for the patient, that patient is excluded from the measure.
  7. Furthermore, for all measures, patients who decline treatment or care are also excluded.
  8. Where possible, these measures were aligned with those developed by other organizations such as the National Quality Forum, Centers for Medicare & Medicaid Services, and the Society of Thoracic Surgeons.
  9. Performance measurement sets serve as vehicles to accelerate translation of scientific evidence into clinical practice and are intended to provide practitioners and institutions with tools to measure the quality of care provided and identify opportunities for improvement.
  10. Coronary artery revascularization is not static but continues to evolve as new techniques, therapies, and treatment strategies emerge, which will require ongoing review and revision of these measures.

Clinical Topics: Acute Coronary Syndromes, Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Prevention, Atherosclerotic Disease (CAD/PAD), Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Acute Heart Failure, Interventions and ACS, Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: Acute Coronary Syndrome, Angiography, Cardiac Surgical Procedures, Coronary Artery Disease, Coronary Vessels, Diagnostic Imaging, Heart Failure, Myocardial Ischemia, Myocardial Revascularization, Patient Care Team, Quality Improvement, Quality of Health Care, Reimbursement, Incentive, Secondary Prevention, Task Performance and Analysis, Vascular Diseases, Work Performance


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