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  • Measure Summary
  • NQMC:008443
  • Mar 2011

Cardiac care: percentage of patients discharged from the critical care department with a main diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) who died.

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in May 2016.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess percentage of patients discharged from the critical care department with a main diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) who died.

Rationale

The aim of intensive care medicine is to provide critical patients with the healthcare that they need, ensuring the quality and safety of care. Intensive care medicine is one of the principal components of modern healthcare systems. There is an increasing demand for this resource, which involves high costs.

The quality of care has gradually come to be the central focus of healthcare, and in recent years patient safety has come to represent one of the key aspects of quality. In the case of intensive care medicine, this interest in quality is even more evident, not only because of its social and economic impact, but also because some of the dimensions involved in the quality of care of critical patients take on greater importance: critical patients are more vulnerable, access to critical care is more limited so efforts to distribute resources equitably are more important, scant scientific evidence is available, and the efficiency is limited.

Although mortality from acute coronary syndrome (ACS) depends on many factors, it is associated with the levels of treatment that the patient receives, so we continue to consider this an indicator of the quality of care.

Evidence for Rationale

Eagle KA, Nallamothu BK, Mehta RH, Granger CB, Steg PG, Van de Werf F, Lopez-Sendon J, Goodman SG, Quill A, Fox KA, Global Registry of Acute Coronary Events (GRACE) Investigators. Trends in acute reperfusion therapy for ST-segment elevation myocardial infarction from 1999 to 2006: we are getting better but we have got a long way to go. Eur Heart J. 2008 Mar;29(5):609-17. PubMed External Web Site Policy

Figueras J, Heras M, Baigorri F, Elosua R, Ferreira I, Santalo M. [III Catalan registry of ST elevation acute myocardial infarction. Comparison with former Catalan registries I and II from Catalonia, Spain]. Med Clin (Barc). 2009 Nov 14;133(18):694-701. PubMed External Web Site Policy

Fox KA, Steg PG, Eagle KA, Goodman SG, Anderson FA Jr, Granger CB, Flather MD, Budaj A, Quill A, Gore JM, GRACE Investigators. Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006. JAMA. 2007 May 2;297(17):1892-900. PubMed External Web Site Policy

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Primary Health Components

Cardiac care; non-ST-segment elevation acute coronary syndrome (NSTE-ACS); hospital mortality

Denominator Description

Number of patients discharged from the intensive care unit (ICU) with a main diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients discharged from the critical care department with a main diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) who died (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Hospital Inpatient

Intensive Care Units

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 18 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

IOM Domain

Effectiveness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Institutionalization

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of patients discharged from the intensive care unit (ICU) with a main diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)

Population: All patients with a main diagnosis of NSTE-ACS discharged from the critical care department (to another ward, to their homes, or due to death) during the period reviewed.

Exclusions

  • Patients transferred to another hospital (due to difficulties in follow-up)
  • Patients with NSTE-ACS identified as a secondary diagnosis because the literature underlying the standard considers only patients with a main diagnosis of NSTE-ACS

Exclusions/Exceptions

System factors addressed

Numerator Inclusions/Exclusions

Inclusions
Number of patients discharged from the critical care department with a main diagnosis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) who died

Note: Death should be considered in-hospital whether it occurs in the intensive care unit (ICU) or in any other department after discharge from the ICU.

Exclusions
Unspecified

Numerator Search Strategy

Institutionalization

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Death

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a lower score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Prescriptive standard

Prescriptive Standard

Standard: less than 4%*

*If the standard is surpassed, the results must be re-evaluated using the risk-adjusted rate.

Evidence for Prescriptive Standard

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Original Title

Hospital mortality in acute coronary syndrome (ACS).

Measure Collection Name

Quality Indicators in Critically Ill Patients

Measure Set Name

Cardiac Care and Cardiopulmonary Resuscitation (CPR)

Submitter

Spanish Society of Intensive and Critical Care and Units Coronary - Clinical Specialty Collaboration

Developer

Spanish Society of Intensive and Critical Care and Units Coronary - Clinical Specialty Collaboration

Funding Source(s)

Boehringer Laboratories

Composition of the Group that Developed the Measure

Work Group for Cardiac Care and Cardiopulmonary Resuscitation (CPR)

  • Ma Paz Fuset Cabanes
  • Miguel Ruano Marco
  • Josep Ma Alcoverro Pedrola
  • Jaime Latour Pérez
  • José Cuñat de la Hoz
  • Frutos del Nogal Sáez
  • Francisco Felices Abad
  • Juan López Messa
  • Emilia Civeira Murillo
  • María Dolores Carrasco González
  • Antonio José Montón Rodríguez

Scientific Coordination:

  • Maria Cruz Martín Delgado
  • Jesús Blanco Varela
  • Lluís Cabré Pericas
  • Pedro Galdos Anuncibay
  • Federico Gordo Vidal

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2011 Mar

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

2016 Jul

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in May 2016.

Source(s)

Quality indicators in critically ill patients. Madrid (Spain): Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC); 2011. 185 p.

Measure Availability

Source available in English External Web Site Policy and Spanish External Web Site Policy from the Spanish Society of Intensive and Critical Care and Units Coronary (SEMICYUC) Web site.

For more information, contact SEMICYUC at Paseo de la Reina Cristina, 36, 4o D, Madrid, Spain; Phone: +34-91-502-12-13; Fax: +34-91-502-12-14; Web site: www.semicyuc.org External Web Site Policy; E-mail: secretaria@semicyuc.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on November 18, 2013. The information was verified by the measure developer on February 6, 2014.

The information was reaffirmed by the measure developer on May 10, 2016.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

The Quality Indicators in Critically Ill Patients update 2011 can be used by any private or public body only for the purposes of research, clinical management, teaching and education, and will not be used for any other purpose. In all cases, full credit to the Spanish Society of Intensive Care Medicine (SEMICYUC) will be granted. The commercial use of the Quality Indicators in Critically Ill Patients update 2011 is explicitly forbidden.

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