New Afib Quality of Care, Performance Measures

— ACC, AHA update now includes inpatient setting, newer risk scale

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An update to performance and quality measures in atrial fibrillation and atrial flutter was jointly issued by the American College of Cardiology and American Heart Association.

The measures, released online in the Journal of the American College of Cardiology and Circulation: Quality and Outcomes, update those released in 2008 and reflect atrial fibrillation guidelines published in 2014.

New in the update were inclusion of the inpatient setting, a switch from CHAD2DS2 to CHA2DS2-VASc risk score, a shared decision-making measure, and care domains such as patient safety, effective clinical care, communication, and care coordination.

The 24 total measures included three for both care settings that were deemed appropriate for public reporting or pay-for-performance programs:

  • Documentation of CHA2DS2-VASc risk score
  • Prescription of anticoagulant medication
  • Planning follow-up to monitor warfarin (Coumadin) prior to discharge and monthly in the outpatient setting

Centers and physicians may choose among the other measures on which to adopt, the document acknowledged.

However, their use "will improve patient care and substantially lower the risk of death or a permanently disabling stroke," task force member Gregg Fonarow, MD, of the University of California Los Angeles, said in a press release.

The ACC said that the measures will be added to its PINNACLE registry for outpatient quality improvement in a future update.

From the American Heart Association:

Primary Source

Circulation: Quality and Outcomes

Source Reference: Heidenreich PA, et al "2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: A report of the American College of Cardiology/American Heart Association Task Force on performance measures" Circ Cardiovasc Qual Outcomes 2016; DOI: 10.1161/HCQ.0000000000000018.