Quality Measures Developed for Pediatric Ambulatory Care

The Leadership Council of the Adult Congenital and Pediatric Cardiology Section (ACPC) has successfully developed quality measures for pediatric ambulatory care. This in turn has led to the development of the ACPC Quality Network as a mechanism to test existing metrics for pediatric cardiology, according to a Council Perspective published Jan. 30 in the Journal of the American College of Cardiology.

ACC’s ACPC Section developed the ACPC Quality Network to give participants and practices an avenue to review and pilot sets of congenital heart disease (CHD) quality metrics across several domains in pediatric cardiology and CHD.

Devyani Chowdhury, MBBS, FACC, a member of the ACPC Section Leadership Council, et al., reviewed the process by which the Council approved the 18 quality metrics for ambulatory pediatric cardiology. This began by identifying five areas of interest that lacked evidence to guide practice or were crosscutting clinical issues, including chest pain, infection prevention, Kawasaki disease, Tetralogy of Fallot and transposition of the great arteries (TGA) after an arterial switch operation.

In developing metrics for consideration, five teams – one per focus area – reviewed published studies that would guide ambulatory practice of pediatric cardiology and identified key decisions and challenges in their focus area. After the five teams submitted a total of 44 proposed quality measures, an expert panel was formed to review each measure, and a four-week open comment period followed the panel’s discussions. The ACPC Section Leadership Council approved 18 quality measures: three related to chest pain, three to infection prevention, seven to Kawasaki disease, four to TGA and one to Tetralogy of Fallot.

“The ACPC Section and Leadership Council used a facilitated RAND process to create a set of quality measures for ambulatory pediatric cardiology that was more successful than prior attempts,” the authors explain. They add that the approved metrics still require testing, and that moving forward, the “ACPC Quality Network is expected to support this testing.”

“In the future, new metrics will be proposed and vetted by Section members who identify an area or gap in care – and a corresponding metric can be developed to test,” explains Kathy J. Jenkins, MD, MPH, FACC, an author of the study and program director of the ACPC Quality Network. “The network is intended to be a flexible tool – allowing for metrics to be discarded, as the need to improve in a certain area becomes less necessary, and replaced with newer ones – where the community agrees a reasonable way to measure practice has been identified.”

Keywords: ACC Publications, Cardiology Magazine, Ambulatory Care, Chest Pain, Heart Defects, Congenital, Mucocutaneous Lymph Node Syndrome, Pediatrics, Tetralogy of Fallot, Transposition of Great Vessels

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