CMAJ: Providers should adopt performance measures for acute MI treatment
Implementation of strategies by clinicians and hospitals to meet target benchmarks on these quality indicators could save the lives of many individuals with acute MI, according to a review in the Oct. 21 issue of the Canadian Medical Association Journal.

Jack V. Tu, MD, PhD, from the Institute for Clinical Evaluative Sciences in Toronto, and colleagues wrote that there is a wide practice gap between optimal and actual care for patients with acute MI in hospitals internationally. The researchers said that they undertook the initiative to develop an updated set of evidence-based indicators to measure and improve the quality of care for this patient population.

The investigators convened a 12-member expert panel in 2007 to develop an updated set of quality indicators for acute MI. The panel identified a list of potential indicators after reviewing the scientific literature, clinical practice guidelines and other published quality indicators. To develop the new list of indicators, the panel rated each potential indicator on four dimensions (reliability, validity, feasibility and usefulness in improving patient outcomes) and discussed the top-ranked quality indicators at a consensus meeting.

The indicators—such as drug therapies upon hospital arrival, assessment and referrals, mortality rates and others—help to measure the quality of cardiac care and identify where heart attack care and patient outcomes can be improved. They were developed by the Canadian Cardiovascular Outcomes Research Team and the Canadian Cardiovascular Society.

Evidence that hospitals with better performance on these indicators have lower mortality rates underscores the fact that using these quality indicators can potentially save many lives. A set of previous indicators has positively impacted the Canadian healthcare system, according to the article’s authors.

“Performance measures are not intended to be an end unto themselves, but rather a critical first step in measuring and improving the care of patients. We suggest that clinicians and hospitals, working collaboratively, use the indicators to measure their performance, assess the results and implement strategies to ensure that every patient with acute MI gets the best possible care and outcomes," according to Tu and colleagues.