Quality Indicators for acute myocardial infarction (AMI) care

The Canadian Cardiovascular Outcomes Research Team (CCORT) was formed in 2001 to conduct studies to measure and improve the outcomes of acute myocardial infarction, congestive heart failure 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 of patient care (e.g., attributes of service providers, organizational characteristics). Process refers to the steps taken in caring for the patient, and outcome refers to the impact on the health status of the patient or 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 AMI quality indicator field have been based primarily in the United States, Australia and the UK. Recognizing the important differences among health care systems, we set out to develop a series of AMI indicators that could be used by clinicians and researchers to measure the quality of AMI 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. 

For further details about the AMI quality indicators, the Canadian Journal of Cardiology publication, and related appendices, please see the following links:

Details

Abridged List of AMI Quality Indicators

PDF CCORT/CCS AMI quality indicators [Can J Cardiol 19(1): 38-45; January 2003]

List of Abbreviations

Appendix 1 – Canadian quality indicators vs US and Australian indicators

Appendix 2 – Structural/organization indicators

Appendix 3A – Diagnostic criteria for AMI

Appendix 3B – Validation criteria for AMI

Appendix 4A – Inpatient process of care indicators (pharmacological)

Appendix 4B – Inpatient process of care indicators (non-pharmacological)

Appendix 5A – Outpatient process of care indicators (pharmacological)

Appendix 5B – Outpatient process of care indicators (non-pharmacological)

Appendix 6 – Outcome indicators

Appendix 7 – Potential variables for risk adjustment for AMI mortality

Appendix 8 – Summary of panel ratings from initial round

Criteria for rating quality indicators

Reference list