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Outpatient cardiac care performance measure compliance showed inconsistencies
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Performance measure compliance with established criteria ranged from low to high extremes for outpatient cardiac care, according to study findings.
Researchers examined compliance with performance measures for 14,464 patients enrolled in the Practice Innovation and Clinical Excellence (PINNACLE) program from July 2008 through June 2009. They measured the proportion of patients whose care was compliant with established American College of Cardiology, American Heart Association and American Medical Association-Physician Consortium for Performance Improvement (PCPI) performance measures for CAD, HF and atrial fibrillation.
Of the 14,464 patients enrolled from 27 U.S. practices, which accounted for 18,021 clinical visits, 8,132 patients (56.4%) had CAD, 5,012 (34.7%) had HF and 2,786 (19.3%) had nonvalvular AF. Performance measure compliance, totaling 24 of 25 ACC/AHA/AMA-PCPI measures, ranged widely from 13.3% of patients with CAD screened for diabetes to 96.7% of patients with HF and BP assessments, with most performance measures in moderate (70% to 90%) compliance.
“We found that compliance with performance measures was variable, even after accounting for exclusion criteria,” the researchers reported. “These results highlight important gaps in the quality of outpatient cardiac care and provide a valuable benchmark for future improvement.”
In an editorial accompanying the Journal of the American College of Cardiology study, Sunil V. Rao, MD, from the Duke Clinical Research Institute, Durham, N.C., commented that these compliance findings can be taken as either good news or bad, depending on which performance measure is viewed.
“The PINNACLE program serves as a reminder that clinical care does not occur in snapshots; it is longitudinal, interrelated, and spans across specialties and diagnoses,” Rao said. “In this context, current quality improvement efforts fall somewhat short, but with the PINNACLE program, many of the necessary pieces are in place to address quality comprehensively.”
Chan P. J Am Coll Cardiol. 2010;56:8-14.