Document Detail

Building quality indicators to improve care for adults with congenital heart disease.
MedLine Citation:
PMID:  24076490     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study sought to develop quality indicators (QIs) for outpatient management of adult congenital heart disease (ACHD) patients.
BACKGROUND: There are no published QIs to promote quality measurement and improvement for ACHD patients.
METHODS: Working groups of ACHD experts reviewed published data and United States, Canadian, and European guidelines to identify candidate QIs. For each QI, we specified a numerator, denominator, period of assessment, and data source. We submitted the QIs to a 9-member panel of international ACHD experts. The panel rated the QIs for validity and feasibility in 2 rounds on a scale of 1 to 9 using the RAND/University of California-Los Angeles modified-Delphi method, and final QI selection was on the basis of median scores.
RESULTS: A total of 62 QIs were identified regarding appropriateness and timing of clinical management, testing, and test interpretation. Each QI was ascertainable from health records. After the first round of rating, 29 QIs were accepted, none were rejected, and 33 were equivocal; on the second round, 55 QIs were accepted. Final QIs included: 8 for atrial septal defects; 9 for aortic coarctation; 12 for Eisenmenger; 9 for Fontan; 9 for D-transposition of the great arteries; and 8 for tetralogy of Fallot.
CONCLUSIONS: This project resulted in development of the first set of QIs for ACHD care based on published data, guidelines, and a modified Delphi process. These QIs provide a quality of care assessment tool for 6 ACHD conditions. This rigorously designed set of QIs should facilitate measuring and improving the quality of care for this growing group of patients.
Michelle Gurvitz; Ariane Marelli; Rita Mangione-Smith; Kathy Jenkins
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-09-27
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  62     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-06     Completed Date:  2014-02-17     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2244-53     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Advisory Committees
Ambulatory Care / standards*
Aortic Coarctation / surgery
Eisenmenger Complex / surgery
Fontan Procedure
Heart Defects, Congenital / surgery*
Heart Septal Defects, Atrial / surgery
Middle Aged
Outcome and Process Assessment (Health Care) / methods,  standards*
Population Surveillance* / methods
Quality Indicators, Health Care / standards*
Research Design
Tetralogy of Fallot / surgery
Transposition of Great Vessels / surgery
United States
Grant Support
7K23HL095908-02/HL/NHLBI NIH HHS; K23 HL095908/HL/NHLBI NIH HHS; //Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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