Table 2.
Current and Proposed Measure Concepts for a Chest Pain Measure Set
| Measure | Current Use** | NQF Endorsement |
|---|---|---|
| Clinical Process/Effectiveness | ||
| Participation in a Systematic National Database for General Thoracic Surgery | Selective adoption | #0456 |
| EKG within 10 minutes of arrival | Available for use | #0090, #0665 |
| EKG for non-traumatic chest pain | PQRS | #0090 |
| Median time to EKG | HOQR | #0289 |
| ASA on arrival | HOQR, PQRS | #0092, #0142, #0286 |
| % AMI patients arriving in ED ≤2 hours after onset of symptoms (SCPC-CP1) | Measure Concept | |
| Time to fibrinolysis | HVBP, HOQR | #0164, #0288 |
| Primary PCI within 90 minutes of hospital arrival for AMI | HBVP | #0163 |
| Undetected missed ACS rate (SCPC CP15) | Measure Concept | |
| Door-in-Door-Out time for STEMI | ||
| Time to CT surgery evaluation for acute ascending aortic dissection | Measure Concept | |
| Population and Public Health | ||
| Tobacco use: Screening and Cessation Intervention | Not specified for emergency physician use | #0028 |
| Patient Safety | ||
| Proportion of (AMI or PNA) patients with potentially avoidable complication | Not specified for emergency physician use | #0704, 0708 |
| Iatrogenic Pneumothorax | Requires new specification for emergency physician use | #0346 |
| Prevention of contrast-induced nephropathy | Measure Concept | |
| Care Coordination | ||
| Communication or results and discharge plan with PMD prior to ED discharge following evaluation for chest pain | Measure Concept | |
| Referral loop closure with primary cardiologist for ED patients with chest pain | Measure Concept | |
| Efficient Use of Healthcare Resources | ||
| Avoidable imaging for patients with low-probability for PE | Available for use | #0667 |
| ACS rule out evaluation rate (SCPC-CP6a) | Measure Concept | |
| ACS rule in evaluation rate (SCPC CP6b) | Measure Concept | |
| Observation usage for low probability chest pain (SCPC PC 16) | Measure Concept | |
| Chest pain ED revisitation rate | Measure Concept | |
| Relative resource use for people with cardiovascular conditions | Not specified for emergency physician use | # 1558 |
| Cardiac stress imaging not meeting appropriate use criteria: Testing in asymptomatic, low risk patient | PQRS | |
| Patient and Family Engagement | ||
| Use of shared decision making to guide evaluation in patients with low risk chest pain | Measure Concept | |
| Percent of chest pain patients who received and understood their diagnosis and care plan at ED discharge | Measure Concept | |
| ED-CAHPS for chest pain patients | Measure Concept |
*National Quality Strategy (NQS) Domains: Patient and Family Engagement, Patient Safety, Care Coordination, Population and Public Health, Efficient use of Healthcare Resources, Clinical Process/Effectiveness
**
HOQR: Hospital Outpatient Quality Reporting; HVBP: Hospital Value-Based Purchasing; pQrS: Physician Quality Reporting System