CCORT/CCS CHF QUALITY INDICATORS
The Canadian Cardiovascular Outcomes Research Team (CCORT) was formed in 2001 to conduct studies to measure and improve the outcomes of acute myocardial infarction (AMI), congestive heart failure (CHF) and cardiac procedure patients in Canada. To accomplish these goals, the CCORT investigators set out to develop, in collaboration with the Canadian Cardiovascular Society (CCS), a series of quality indicators that could serve as a foundation for future studies of cardiovascular care in Canada.
Quality indicators assess health care structure, processes and outcomes. Structure refers to static or technical aspects (e.g. attributes of service providers, organizational characteristics). Process refers to the steps taken in caring for the patient, and outcomes refers to the impact on the health status of the patient or the population. Indicators are distinct from practice guidelines in that they are intended for measuring actual practice patterns as compared with guidelines, which suggest optimal practice patterns.
Previous efforts in the CHF quality indicator field have been based primarily in the United States. The National Heart Failure Quality Improvement Project and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) have also developed guideline-based quality indicators and have measured them using primary data abstraction. These indicators were based on recommendations from the Agency for Health Care Policy and Research (AHCPR) and the ACC/AHA CHF Task Force Report guidelines.
Because of important differences in the Canadian and US healthcare systems, we set out to develop a series of CHF indicators that could be used by clinicians and researchers to measure the quality of CHF care in Canada. Although they will require modification over time, the CCORT investigators hope that these quality indicators will serve as a starting point for future studies in this area.
Further information regarding the CHF quality indicators, the Canadian Journal of Cardiology publication, and related appendices are available through the following links:
Abridged List of CHF Quality Indicators
PDF CCORT/CCS CHF quality indicators [Can J Cardiol 19(4): 357-364; March 2003]
List of Abbreviations
Appendix 1: CCORT/CCS Quality Indicators for CHF Care versus US Indicators
Appendix 2: Structural / Organizational Indicators
Appendix 3A: Diagnostic Criteria for CHF – Inclusion and Exclusion
Appendix 3B: Diagnostic Criteria for CHF – Validation Criteria
Appendix 4A: Inpatient Process Indicators (Pharmacological)
Appendix 4B: Inpatient Process Indicators (Nonpharmacological)
Appendix 5A: Outpatient Process Indicators (Pharmacological)
Appendix 5B: Outpatient Process Indicators (Nonpharmacological)
Appendix 6: Outcomes Indicators
Appendix 7: Variables for Risk Adjustment
Appendix 8 Summary of Panel Ratings from Initial Round
Criteria for rating quality indicators