Report: Performance measures should include patient actions

PUBLIC RELEASE DATE:

3-Nov-2014

Contact: Rachel Cagan rcagan@acc.org 202-375-6395 American College of Cardiology @ACCinTouch

WASHINGTON (Nov. 3, 2014) The actions or inaction of patients should be considered in programs designed to improve care and patient outcomes, according to a report released today by the American College of Cardiology, American Heart Association, American Association of Cardiovascular and Pulmonary Rehabilitation, American Academy of Family Physicians and the American Nurses Association in collaboration with other professional organizations.

The work of doctors and other clinicians is often evaluated based on "performance measures," specific measurable steps that should be taken or avoided in treating patients for specific conditions. For instance, whether aspirin is given within the first 24 hours of a patient arriving at a hospital having a heart attack is an important performance measure.

Incorporating both clinicians and patients into shared-accountability performance measures may be an important way to improve patient-centered outcomes, morbidity, and mortality, according to the report, "The Concepts for ClinicianPatient Shared Accountability in Performance Measures," which was published online today.

The report was developed in collaboration with the National Committee for Quality Assurance, the American Society of Health System Pharmacists, and the American Medical Associationconvened Physician Consortium for Performance Improvement. It is endorsed by the American Society of Health-System Pharmacists.

While performance measures have traditionally been clinician focused, their goal of improving patient outcomes is heavily dependent on the healthcare system as well as patient actions. Recognizing this, the developing organizations sought to outline the key concepts, measurements, and considerations for implementing patient-clinician shared-accountability performance measures.

Shared-accountability performance measures track patient actions that affect outcomessuch as following treatment plans, taking medications as prescribed, going to follow up appointments, and maintaining lifestyle changesalong with physician processes. The use of shared-accountability performance measures, which recognizes the "inextricably linked" nature of patient and clinician action, has been advocated by the Institute of Medicine.

In order to implement shared-accountability performance measures, patients must have "sufficient support and knowledge to actively participate in their health care," the report says. Shared goal setting, shared decision making, and shared care planning and monitoring between patient and clinician are all important concepts to implement as part of shared-accountability performance measures, the report said.

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Report: Performance measures should include patient actions