ACC/AHA Publish 2023 Clinical Performance Measures for Coronary Revascularization

July 28, 2023—The American Heart Association (AHA) and the American College of Cardiology (ACC) separately announced the publication of a report from the ACC/AHA Joint Committee on Performance Measures that addresses clinical performance and quality measures for coronary artery revascularization.

The report by Gregory J. Dehmer, MD, et al is available in both AHA’s Circulation: Cardiovascular Quality and Outcomes and ACC’s Journal of the American College of Cardiology.

As outlined in the report, the “take-home messages” for coronary artery revascularization are the following:

1. This document describes performance measures for coronary revascularization that are appropriate for public reporting or pay-for-performance programs.
2. This is the first joint AHA/ACC document developing measures related to coronary artery revascularization.
3. Most performance measures were developed from the “2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization”—which the societies published with the Society for Cardiovascular Angiology and Interventions (SCAI) in December 2021—and are selected from the strongest recommendations (class 1 or 3).
4. Quality measures are included as metrics that may be useful for local quality improvement programs but are not yet appropriate for public reporting or pay-for-performance programs.
5. Structural measures are useful to assess infrastructure, systems, and processes of care. Two structural measures were developed. One structural measure is related to the presence and function of the Heart Team and the other structural measure is related to registry participation.
6. For all measures, if the clinician determines the guideline-recommended care is inappropriate for the patient, that patient is excluded from the measure.
7. For all measures, patients who decline treatment or care are excluded.
8. Where possible, these measures were aligned with those developed by other organizations such as the National Quality Forum, Centers for Medicare & Medicaid Services, and the Society of Thoracic Surgeons.
9. Performance measurement sets serve as vehicles to accelerate translation of scientific evidence into clinical practice and are intended to provide practitioners and institutions with tools to measure the quality of care provided and identify opportunities for improvement.
10. Coronary artery revascularization is not static but continues to evolve as new techniques, therapies, and treatment strategies emerge, which will require ongoing review and revision of these measures.