2016 ACC/AHA Clinical Performance and Quality Measures for Adults With Atrial Fibrillation or Atrial Flutter A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures
2016 ACC/AHA Clinical Performance and Quality Measures for Adults With Atrial Fibrillation or Atrial Flutter A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures
复制标题
DOI：
10.1016/j.jacc.2016.03.521
复制
发表时间：
2016-07-01
影响因子：
6.9
通讯作者：
Varosy, Paul D.
中科院分区：
文献类型：
--
作者：
Heidenreich, Paul A.;Solis, Penelope;Varosy, Paul D.
2015年夏天，ACC/AHA召集了写作委员会，开始修订现有的心房颤动（AF）和心房扑动测量集，该测量集于2008年发布，并于2011年发布了实施说明。编写委员会还负责制定新的措施，以基准和提高对房颤或心房扑动患者的护理质量。在整个报告中，术语房颤包括心房扑动，除非特别说明。表1简要总结了临床表现和质量测量集中包含的所有测量，其中提供了测量号，测量标题和护理环境的信息。详细的测量规范（可在附录A中获得）不仅提供表1中的信息，还提供更详细的信息，包括测量描述、分子、分母（包括分母排除和例外）、测量的基本原理、支持测量的指导方针、测量周期、数据来源和归因。由于几个原因，这种房颤临床表现和质量测量集是值得注意的。首先，写作委员会考虑是否应该为住院病人制定措施，扩大原有措施集的范围。具体来说，写作委员会决定扩大护理环境，从单一的门诊环境到住院环境，通过解决他们接受护理的多种环境，进一步提高对这些患者的护理的连续性。其次，针对以前未涉及的护理领域制定了新的措施，包括患者安全、有效的临床护理、沟通和护理协调。考虑了许多度量概念，但在委员会讨论后最终没有包括在这一套中。本写作委员会希望，随着新科学的发展和电子健康记录数据标准在各种环境中得到更广泛的实施，将重新评估这一临床表现和质量衡量标准。
In the summer of 2015, the ACC/AHA convened the writing committee to begin the process of revising the existing atrial fibrillation (AF) and atrial flutter measure set that was released in 20082 and for which implementation notes had been issued in 2011. 3 The writing committee also was charged with the task of developing new measures to benchmark and improve the quality of care for patients with AF or atrial flutter. Throughout the report, the term AF will include atrial flutter, unless specifically stated.All the measures included in the clinical performance and quality measure set are briefly summarized in Table 1, which provides information on the measure number, measure title, and care setting. The detailed measure specifications (available in Appendix A) provide not only the information included in Table 1 but also more detailed information, including the measure description, numerator, denominator (including denominator exclusions and exceptions), rationale for the measure, guidelines that support the measure, measurement period, source of data, and attribution. This AF clinical performance and quality measure set is notable for several reasons. First, the writing committee considered whether measures should be developed for the inpatient setting, expanding the scope of the original measure set. Specifically, the writing committee decided to broaden the care setting, from a solely outpatient context to the inpatient setting, to further improve the continuity of care for these patients by addressing the multiple settings in which they receive care. Second, new measures were developed for care domains that were not previously addressed, including patient safety, effective clinical care, communication, and care coordination. Many measure concepts were considered but were ultimately not included in this set after committee discussion. It is the hope of this writing committee that this clinical performance and quality measure set will be reassessed as new science is developed and as electronic health record data standards are more broadly implemented across settings.