BACKGROUND: There is a wide practice gap between optimal and actual care for patients with acute myocardial infarction in hospitals around the world. We undertook this initiative to develop an updated set of evidence-based indicators to measure and improve the quality of care for this patient population. METHODS: A 12-member expert panel was convened in 2007 to develop an updated set of quality indicators for acute myocardial infarction. The panel identified a list of potential indicators after reviewing the scientific literature, clinical practice guidelines and other published quality indicators. To develop the new list of indicators, the panel rated each potential indicator on 4 dimensions (reliability, validity, feasibility and usefulness in improving patient outcomes) and discussed the top-ranked quality indicators at a consensus meeting. RESULTS: Consensus was reached on 38 quality indicators: 17 that would be measurable using chart-abstracted data and 21 that would be measurable using administrative data. Of the 17 chart-review indicators, 13 address pharmacologic and nonpharmacologic care delivered to patients in hospital. In-hospital mortality was recommended as a key outcome indicator. Three system indicators were recommended to measure the collaborative responsiveness of the health care system from the call for help to intervention. It was recommended that hospitals strive for a minimum target benchmark of 90% or greater on process-of-care indicators. INTERPRETATION: Implementation of strategies by clinicians and hospitals to meet target benchmarks on these quality indicators could save the lives of many individuals with acute myocardial infarction.
BACKGROUND: There is a wide practice gap between optimal and actual care for patients with acute myocardial infarction in hospitals around the world. We undertook this initiative to develop an updated set of evidence-based indicators to measure and improve the quality of care for this patient population. METHODS: A 12-member expert panel was convened in 2007 to develop an updated set of quality indicators for acute myocardial infarction. The panel identified a list of potential indicators after reviewing the scientific literature, clinical practice guidelines and other published quality indicators. To develop the new list of indicators, the panel rated each potential indicator on 4 dimensions (reliability, validity, feasibility and usefulness in improving patient outcomes) and discussed the top-ranked quality indicators at a consensus meeting. RESULTS: Consensus was reached on 38 quality indicators: 17 that would be measurable using chart-abstracted data and 21 that would be measurable using administrative data. Of the 17 chart-review indicators, 13 address pharmacologic and nonpharmacologic care delivered to patients in hospital. In-hospital mortality was recommended as a key outcome indicator. Three system indicators were recommended to measure the collaborative responsiveness of the health care system from the call for help to intervention. It was recommended that hospitals strive for a minimum target benchmark of 90% or greater on process-of-care indicators. INTERPRETATION: Implementation of strategies by clinicians and hospitals to meet target benchmarks on these quality indicators could save the lives of many individuals with acute myocardial infarction.
Authors: Harlan M Krumholz; Jeffrey L Anderson; Neil H Brooks; Francis M Fesmire; Costas T Lambrew; Mary Beth Landrum; W Douglas Weaver; John Whyte; Robert O Bonow; Susan J Bennett; Gregory Burke; Kim A Eagle; Jane Linderbaum; Frederick A Masoudi; Sharon-Lise T Normand; Ileana L Piña; Martha J Radford; John S Rumsfeld; James L Ritchie; John A Spertus Journal: Circulation Date: 2006-01-03 Impact factor: 29.690
Authors: John A Spertus; Kim A Eagle; Harlan M Krumholz; Kristi R Mitchell; Sharon-Lise T Normand Journal: Circulation Date: 2005-04-05 Impact factor: 29.690
Authors: Peter K Lindenauer; Denise Remus; Sheila Roman; Michael B Rothberg; Evan M Benjamin; Allen Ma; Dale W Bratzler Journal: N Engl J Med Date: 2007-01-26 Impact factor: 91.245
Authors: Kim A Eagle; Brahmajee K Nallamothu; Rajendra H Mehta; Christopher B Granger; Philippe Gabriel Steg; Frans Van de Werf; Jose López-Sendón; Shaun G Goodman; Ann Quill; Keith A A Fox Journal: Eur Heart J Date: 2008-03 Impact factor: 29.983
Authors: John A Spertus; Martha J Radford; Nathan R Every; Edward F Ellerbeck; Eric D Peterson; Harlan M Krumholz Journal: Circulation Date: 2003-04-01 Impact factor: 29.690
Authors: Elliott M. Antman; Daniel T. Anbe; Paul Wayne Armstrong; Eric R. Bates; Lee A. Green; Mary Hand; Judith S. Hochman; Harlan M. Krumholz; Frederick G. Kushner; Gervasio A. Lamas; Charles J. Mullany; Joseph P. Ornato; David L. Pearle; Michael A. Sloan; Sidney C. Smith; Joseph S. Alpert; Jeffrey L. Anderson; David P. Faxon; Valentin Fuster; Raymond J. Gibbons; Gabriel Gregoratos; Jonathan L. Halperin; Loren F. Hiratzka; Sharon Ann Hunt; Alice K. Jacobs; Joseph P. Ornato Journal: J Am Coll Cardiol Date: 2004-08-04 Impact factor: 24.094
Authors: Jeffrey L Anderson; Cynthia D Adams; Elliott M Antman; Charles R Bridges; Robert M Califf; Donald E Casey; William E Chavey; Francis M Fesmire; Judith S Hochman; Thomas N Levin; A Michael Lincoff; Eric D Peterson; Pierre Theroux; Nanette Kass Wenger; R Scott Wright; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffrey L Anderson; Elliott M Antman; Jonathan L Halperin; Sharon A Hunt; Harlan M Krumholz; Frederick G Kushner; Bruce W Lytle; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: J Am Coll Cardiol Date: 2007-08-14 Impact factor: 24.094
Authors: Anna Chu; Lu Han; Idan Roifman; Douglas S Lee; Michael E Green; Kristen Jacklin; Jennifer Walker; Roseanne Sutherland; Shahriar Khan; Eliot Frymire; Jack V Tu; Baiju R Shah Journal: CMAJ Date: 2019-11-25 Impact factor: 8.262
Authors: Jack V Tu; Laura C Maclagan; Dennis T Ko; Clare L Atzema; Gillian L Booth; Sharon Johnston; Karen Tu; Douglas S Lee; Arlene Bierman; Ruth Hall; R Sacha Bhatia; Andrea S Gershon; Sheldon W Tobe; Claudia Sanmartin; Peter Liu; Anna Chu Journal: CMAJ Open Date: 2017-04-25
Authors: Lauren C Bresee; Merril L Knudtson; Jianguo Zhang; Lynden Lindsay Crowshoe; Sofia B Ahmed; Marcello Tonelli; William A Ghali; Hude Quan; Braden Manns; Gabriel Fabreau; Brenda R Hemmelgarn Journal: CMAJ Date: 2014-05-20 Impact factor: 8.262
Authors: Adolfo Peña; Sandeep S Virk; Richard M Shewchuk; Jeroan J Allison; O Dale Williams; Catarina I Kiefe Journal: Int J Qual Health Care Date: 2010-04-09 Impact factor: 2.038