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Measuring quality in electrophysiology

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

The evolving healthcare environment demands optimally measured quality of care. Performance measures are increasingly being used for quality improvement, public reporting, and reimbursement determinations. The National Quality Forum has created rigorous criteria for the evaluation of potential performance measures across medical fields. The Heart Rhythm Society has championed the development of four separate electrophysiology (EP)-specific performance measures: implantable cardioverter defibrillator complication rate, cardiac tamponade and/or pericardiocentesis following atrial fibrillation ablation, infection within 180 days of a cardiac implantable electronic device implantation, replacement, or revision, and in-person evaluation following a cardiac implantable electronic device implantation. National registries serve a key role in developing performance measures and facilitating quality improvement, particularly as they provide improved granularity and accuracy of data compared with administrative claims data. All performance measures demand continued reassessment as technology and performance gaps change and as unintended consequences may arise.

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References

  1. National Strategy for Quality Improvement in Health Care (2011). http://www.ahrq.gov/workingforquality/nqs/nqs2011annlrpt.pdf. Accessed September 29 2015.

  2. Crossing the quality chasm: the IOM Health Care Quality Initiative. http://iom.nationalacademies.org/Global/News%20Announcements/Crossing-the-Quality-Chasm-The-IOM-Health-Care-Quality-Initiative.aspx#sthash.RJShNiJ4.anTRQqHw.dpuf. Accessed December 7 2015.

  3. Measure evaluation criteria and guidance for evaluating measures for endorsement (2015). http://www.qualityforum.org/Measuring_Performance/Submitting_Standards/2015_Measure_Evaluation_Criteria.aspx. Accessed September 29 2015.

  4. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators (1991). The New England Journal of Medicine, 325(5), 293–302.

  5. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF) (1999). Lancet, 353(9169), 2001–2007.

  6. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. The SOLVD Investigattors (1992). The New England Journal of Medicine, 327(10), 685–691.

  7. Packer, M., Bristow, M. R., Cohn, J. N., Colucci, W. S., Fowler, M. B., Gilbert, E. M., et al. (1996). The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. carvedilol heart failure study group. The New England Journal of Medicine, 334(21), 1349–1355.

    Article  CAS  PubMed  Google Scholar 

  8. PQRS 2015 Measure List. https://www.cms.gov/apps/ama/license.asp?file=/PQRS/Downloads/PQRS_2015_Measure-List_111014.zip. Accessed September 17 2015.

  9. Physician quality reporting system (2015). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/. Accessed September 17 2015.

  10. Dodson, J. A., Reynolds, M. R., Bao, H., Al-Khatib, S. M., Peterson, E. D., Kremers, M. S., et al. (2014). Developing a risk model for in-hospital adverse events following implantable cardioverter-defibrillator implantation: a report from the NCDR (National Cardiovascular Data Registry). Journal of the American College of Cardiology, 63(8), 788–796.

    Article  PubMed  Google Scholar 

  11. Prutkin, J. M., Reynolds, M. R., Bao, H., Curtis, J. P., Al-Khatib, S. M., Aggarwal, S., et al. (2014). Rates of and factors associated with infection in 200 909 Medicare implantable cardioverter-defibrillator implants: results from the national cardiovascular data registry. Circulation, 130(13), 1037–1043.

    Article  PubMed  Google Scholar 

  12. Lewis, W. R., Piccini, J. P., Turakhia, M. P., Curtis, A. B., Fang, M., Suter, R. E., et al. (2014). Get with the guidelines AFIB: novel quality improvement registry for hospitalized patients with atrial fibrillation. Circulation. Cardiovascular Quality and Outcomes, 7(5), 770–777.

    Article  PubMed  Google Scholar 

  13. RW, B. N. a. Y. Is door-to-balloon time a misleading metric?. https://www.acc.org/latest-in-cardiology/articles/2015/06/03/13/23/is-door-to-balloon-time-a-misleading-metric?w_nav=TI. Accessed September 17 2015.

  14. Krumholz, H. M., Herrin, J., Miller, L. E., Drye, E. E., Ling, S. M., Han, L. F., et al. (2011). Improvements in door-to-balloon time in the United States, 2005 to 2010. Circulation, 124(9), 1038–1045.

    Article  PubMed  PubMed Central  Google Scholar 

  15. McCabe, J. M., Kennedy, K. F., Eisenhauer, A. C., Waldman, H. M., Mort, E. A., Pomerantsev, E., et al. (2014). Reporting trends and outcomes in ST-segment-elevation myocardial infarction national hospital quality assessment programs. Circulation, 129(2), 194–202.

    Article  PubMed  Google Scholar 

  16. Wimmer, N. J., Cohen, D. J., Wasfy, J. H., Rathore, S. S., Mauri, L., & Yeh, R. W. (2014). Delay in reperfusion with transradial percutaneous coronary intervention for ST-elevation myocardial infarction: Might some delays be acceptable? American Heart Journal, 168(1), 103–109.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gasparini, M., Proclemer, A., Klersy, C., Kloppe, A., Lunati, M., Ferrer, J. B., et al. (2013). Effect of long-detection interval vs standard-detection interval for implantable cardioverter-defibrillators on antitachycardia pacing and shock delivery: the ADVANCE III randomized clinical trial. JAMA, 309(18), 1903–1911.

    Article  CAS  PubMed  Google Scholar 

  18. Moss, A. J., Schuger, C., Beck, C. A., Brown, M. W., Cannom, D. S., Daubert, J. P., et al. (2012). Reduction in inappropriate therapy and mortality through ICD programming. The New England Journal of Medicine, 367(24), 2275–2283.

    Article  CAS  PubMed  Google Scholar 

  19. Varma, N., Piccini, J. P., Snell, J., Fischer, A., Dalal, N., & Mittal, S. (2015). The relationship between level of adherence to automatic wireless remote monitoring and survival in pacemaker and defibrillator patients. Journal of the American College of Cardiology, 65(24), 2601–2610.

    Article  PubMed  Google Scholar 

  20. Saxon, L. A., Hayes, D. L., Gilliam, F. R., Heidenreich, P. A., Day, J., Seth, M., et al. (2010). Long-term outcome after ICD and CRT implantation and influence of remote device follow-up: the ALTITUDE survival study. Circulation, 122(23), 2359–2367.

    Article  PubMed  Google Scholar 

  21. Slotwiner, D., Varma, N., Akar, J. G., Annas, G., Beardsall, M., Fogel, R. I., et al. (2015). HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm, 12(7), e69–e100.

    Article  PubMed  Google Scholar 

  22. Wilkoff, B. L., Fauchier, L., Stiles, M. K., Morillo, C. A., Al-Khatib, S. M., Almendral, J., et al. (2016). 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Heart Rhythm, 13(2), e50–86. doi:10.1016/j.hrthm.2015.11.018.

  23. The merit-based incentive payment system (MIPS) & alternative payment models (APMs): delivery system reform, medicare payment reform, & the MACRA (2015). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html. Accessed December 7 2015.

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Correspondence to Sana M. Al-Khatib.

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Friedman, D.J., Al-Khatib, S.M. Measuring quality in electrophysiology. J Interv Card Electrophysiol 47, 5–10 (2016). https://doi.org/10.1007/s10840-016-0118-5

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  • DOI: https://doi.org/10.1007/s10840-016-0118-5

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