Translating evidence-based guidelines into performance measures for venous thromboembolism and acute coronary syndrome

Purpose. The evolution of evidence-based quality measures in healthcare, specific performance measures that have been developed by various groups for the prevention and treatment of venous thromboembolism (VTE), the objectives and potential benefits of a national quality improvement initiative designed to improve the care of high-risk patients with acute coronary syndrome (ACS), the reporting of performance data to the public to guide consumer choice, and the recent growth in pay-for-performance programs are described. Summary. Efforts to develop evidence-based quality measures began in the mid to late 1990s and have led to the creation of various safe practices, indicators, standards, and quality measures and initiatives. The prevention and treatment of VTE and the management of ACS have been the focus of some of these initiatives. Reporting of data for two surgery-related VTE process measures to the Centers for Medicare and Medicaid Services began January 1, 2007, and two additional measures may be used in the future. The Joint Commission and National Quality Forum have proposed eight core measures for the prevention and care of VTE that could eventually be used in hospital accreditation decisions. A national quality improvement initiative, CRUSADE, provides participating hospitals with feedback about performance in caring for high-risk patients with non-ST-segment elevation ACS. Reporting of performance data to the public facilitates healthcare decision making by consumers. The use of pay-for-performance programs that provide incentives and rewards for meeting quality goals has grown rapidly in recent years. Conclusion. The various initiatives under way using evidence-based performance measures to evaluate quality of care for VTE and ACS have the potential to improve patient outcomes.