American College of Cardiology and American Heart Association Methodology for the Selection and Creation of Performance Measures for Quantifying the Quality of Cardiovascular Care

Abstract—The ability to quantify the quality of cardiovascular care critically depends on the translation of recommenda-tions for high-quality care into the measurement of that care. As payers and regulatory agencies increasingly seek to quantify healthcare quality, the implications of the measurement process on practicing physicians are likely to grow. This statement describes the methodology by which the American College of Cardiology and the American Heart Association approach creating performance measures and devising techniques for quantifying those aspects of care that directly reflect the quality of cardiovascular care. Methods for defining target populations, identifying dimensions of care, synthesizing the literature, and operationalizing the process of selecting measures are proposed. It is hoped that new sets of measures will be created through the implementation of this approach, and consequently, through the use of such measurement sets in the context of quality improvement efforts, the quality of cardiovascular care will improve. (Circulation. 2005;111:1703-1712.) Key Words: ACC/AHA Performance Measures cardiovascular diseases healthcare quality policy making Medicine is experiencing an unprecedented increasedfocus on quantifying and improving the quality of health care. Although healthcare quality is a multidimen-sional construct that, as articulated by the Institute of Medi-cine,1 encompasses concepts of safety, equity, evidence