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Public Reporting of Cardiovascular Data. Overview. Public Reporting Cardiovascular Data Recommendations. Healthcare providers need reliable quality and comparative performance information to advance their quality improvement efforts.
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Overview Public Reporting Cardiovascular Data Recommendations
Healthcare providers need reliable quality and comparative performance information to advance their quality improvement efforts. Consumers need reliable information to make informed decisions about their care.
Comparative Effectiveness • What is being compared • What are the metrics of comparison • Who is performing the comparison
National Cardiovascular Data Registry Structural Heart “TAVR” Atrial Fibrillation
STS National Database > 90 % of Cardiothoracic Surgery Practices participate in database
Important Feedback for Program Results Both registries are risk adjusted data
ACC-NCDR Blank Data Collection Form Sample Report
ACC-AHA,AHRQ Public Reporting Consensus Statement • Risk adjusted • Timely • Sufficient in sample size • Increase value to consumers and providers • Include a relevant time period • Easy to use • Provide explanations and methodology Above all information must be valid and reliable 1. Krumholz et al, Standards for Statistical Models Used for Public Reporting of Health Outcomes. An American Heart Association Scientific Statement From the Quality of Care and Outcomes Research Interdisciplinary Writing Group. Circulation 2005 doi:10.1161/CIRCULATIONAHA.105.170769 2. Hibbard J, Sofaer S. Best Practices in Public Reporting No. 2: Maximizing Consumer Understanding of Public Comparative Quality Reports: Effective Use of Explanatory Information. AHRQ Publication No. 10-0082-EF, May 2010,
Public Reporting Recommendations • Supportive of transparency and public reporting • Participate in a federally accredited PSO • Only requested risk adjusted outcomes data provided • Require a valid inter-rater reliability process • Mandatory vs. voluntary reporting • STS presently physician owned data and would require further processing
Public Reporting Principles • Risk Adjusted data only • Focus on vital few vs useful many • No more than 3-5 measures • Clear and Concise • Establish a valid Inter-rater reliability process • Timely (concurrent abstracting or within 6 months)
What ACC measures are recommended? • Door to Balloon times • PCI inhospital risk adjusted mortality (all patients) • Volumes (significant sample size) • Stemi (100) • Elective Angioplasties (300) • Annual volume numbers only • If <100 Stemi– report “inadequate sample size to be reported” • If <300 Elective PCI – report “inadequate sample size to be reported”
What STS measures are recommended? • CABG only (no redo’s) • Mortality (as observed/expected) • CABG Volumes (significant sample size) • Annual volume numbers only • If <100 CABG– report “inadequate sample size to be reported” • *Indicate programs that provide Heart Transplant services*