Assessing Performance and Quality After Non-ST Segment Elevation Acute Coronary Syndromes
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Purpose of Review
This review summarizes and discusses the evidence base supporting current performance and quality measures used in assessing institutions in their care of patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS).
Professional societies in the USA and Europe have developed performance and quality measures for NSTE-ACS. These measures are reviewed and updated periodically to reflect the most important evidence from the literature. In the USA, the ACC/AHA Task Force on Performance Measures published the updated 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction. In Europe, the ESC Acute Cardiac Care Association published the 2017 Quality Indicators for acute myocardial infarction. These documents build on guidelines previously developed and published by the two organizations. They include detailed reviews of current and past studies establishing that adherence with guidelines improves clinical outcomes. Both measure sets provide quantitative methodologies to assess program performance. Institutional programs that focus on these validated measures can increase guideline adherence, streamline and standardize care processes, and reduce morbidity and mortality.
Performance and quality measures have become a critical part of healthcare today, allowing patients, providers, administrators, and payors to assess patient care objectively. They are also becoming an important component of value-based payment programs. To be fair, and useful, for internal institutional assessment, in comparing different institutions, and for value-based payments, only validated performance measures such as these should be employed.
KeywordsQuality measures Performance measures Non-ST segment elevation acute coronary syndromes
American College of Cardiology
ACC/AHA Task Force on Performance Measures
Acute coronary syndrome
American Heart Association
Acute myocardial infarction
Angiotensin receptor blocker
Coronary artery bypass surgery
Dual antiplatelet therapy
European Society of Cardiology
Get with the Guidelines-Coronary Artery Disease Program
Left ventricular systolic dysfunction
National Cardiovascular Data Registries
Non-ST segment elevation-acute coronary syndrome
Non-ST segment elevation myocardial infarction
Percutaneous coronary intervention
ST segment elevation myocardial infarction
Compliance with Ethical Standards
Conflict of Interest
H. Vernon Anderson and Robin Jacob declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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