2018 ACC/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures

• Published in: Journal of the American College of Cardiology Vol. 71; no. 16; pp. 1814 - 1837
• Main Authors: Thomas, Randal J, Balady, Gary, Banka, Gaurav, Beckie, Theresa M, Chiu, Jensen, Gokak, Sana, Ho, P Michael, Keteyian, Steven J, King, Marjorie, Lui, Karen, Pack, Quinn, Sanderson, Bonnie K, Wang, Tracy Y
• Format: Journal Article Conference Proceeding
• Language: English
• Published: United States Elsevier Limited 24-04-2018
• Subjects: Cardiology; Cardiovascular disease; Clinical outcomes; Communication; Documentation; Enrollments; Fitness training programs; Health care policy; Heart attacks; Heart diseases; Heart surgery; Hospitals; Long term health care; Medical records; Mortality; Nursing care; Participation; Patients; Primary care; Quality control; Quality of life; Rehabilitation; Task forces; Writing; ACC/AHA Performance Measures; performance measures; quality indicators; quality measures; cardiac rehabilitation
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2018.01.004

[...]the programs provide patient-centered disease management education aimed to progress patients toward improved outcomes in the clinical, functional, and behavioral domains. Denominator All patients with a qualifying event/diagnosis in the previous 12 mo including: MI, PCI, CABG, CSA, valve repair/replacement, or heart transplantation, who are discharged from the hospital during the reporting period Denominator Exclusions ▪Patients age <18 y▪Patients who leave during hospitalization against medical advice▪Patients who die during hospitalization▪Patients who are transferred to another hospital for inpatient care▪Patients who are already participating in a CR program before hospitalization Denominator Exceptions ▪Documentation of a patient-oriented reason that precludes referral to CR (e.g., no traditional CR program available to the patient, within 60 min [travel time] from the patient’s home, or patient does not have access to an alternative model of CR delivery that meets all criteria for a CR program)▪Documentation of a medical reason that precludes referral to CR (e.g., patient deemed by a medical provider to have a medically unstable, life-threatening condition or has other cognitive or physical impairments that preclude CR participation)▪Documentation of a healthcare system reason that precludes referral to CR (e.g., patient is discharged to a nursing care or long-term care facility, or patient lacks medical coverage for CR) Measurement Period Encounter Sources of Data Medical record or other database (e.g., administrative, clinical, registry) Attribution Measure reportable at facility level Care Setting Inpatient PM-1 Referral From Inpatient Setting PM-2: Exercise Training Referral for HFrEF From an Inpatient Setting Measure Description: Percentage of patients, age ≥18 y, hospitalized with a primary diagnosis of HFrEF in the previous 12 mo, who are referred for outpatient exercise training (or regular physical activity), typically delivered in the setting of an outpatient CR program. Denominator All patients who have had HFrEF during the previous 12 mo, who are discharged from the hospital during the reporting period Denominator Exclusions ▪Patients age <18 y▪Patients who leave during hospitalization against medical advice▪Patients who die during hospitalization▪Patients who are transferred to another hospital for inpatient care▪Patients who are already participating in a CR program before hospitalization Denominator Exceptions ▪Documentation of a patient-oriented reason that precludes referral to CR (e.g., no traditional CR program available to the patient, within 60 min [travel time] from the patient’s home, or patient does not have access to an alternative model of CR delivery that meets all criteria for a CR program)▪Documentation of a medical reason that precludes referral to CR (e.g., patient deemed by a medical provider to have a medically unstable, life-threatening condition or has other cognitive or physical impairments that preclude CR participation)▪Documentation of a healthcare system reason that precludes referral to CR (e.g., patient is discharged to a nursing care or long-term care facility, or patient lacks medical coverage for CR) Measurement Period Encounter Sources of Data Medical record or other database (e.g., administrative, clinical, registry) Attribution Measure reportable at facility level Care Setting Inpatient PM-2 Exercise Training Referral for HFrEF From Inpatient Setting PM-3: Cardiac Rehabilitation Patient Referral From an Outpatient Setting Measure Description: Percentage of patients, age ≥18 y, evaluated in an outpatient setting, who within the previous 12 mo have had a qualifying event/diagnosis for CR including: MI, CABG surgery, a PCI, cardiac valve surgery, or heart transplantation, or who have CSA and have not already participated in a CR program for the qualifying event/diagnosis are to be referred to such a program. Denominator All patients in an outpatient clinical practice who have had HFrEF during the previous 12 mo Denominator Exclusions ▪Patients age <18 y▪Patients who leaves clinic visit against medical advice▪Patients have already participated in or had already completed a CR program prior to clinic visit Denominator Exceptions ▪Documentation of a patient-oriented reason that precludes referral to CR (e.g., no traditional CR program available to the patient, within 60 min [travel time] from the patient’s home, or patient does not have access to an alternative model of CR delivery that meets all criteria for a CR program)▪Documentation of a medical reason that precludes referral to CR (e.g., patient deemed by a medical provider to have a medically unstable, life-threatening condition or has other cognitive or physical impairments that preclude CR participation)▪Documentation of a healthcare system reason that precludes referral to CR (e.g., patient resides in a nursing care or long-term care facility, or patient lacks medical coverage for CR) Measurement Period Encounter Sources of Data Medical record or other database (e.g., administrative, clinical, registry) Attribution Measure reportable at provider and facility level Care Setting Outpatient PM-4 Exercise Training Referral for HFrEF From Outpatient Setting PM-5A: Cardiac Rehabilitation Enrollment (Claims-Based) Measure Description: Percentage of patients, age ≥18 y, with a qualifying event/diagnosis for CR including: MI, PCI, CABG, CSA, valve repair/replacement, or heart transplantation, who attend at least 1 session in a CR program.