Using clinical indicators in a quality improvement programme targeting cardiac care.

Area of Science:

• Healthcare Quality Improvement
• Clinical Performance Measurement
• Cardiovascular Medicine

Background:

• The Brisbane Cardiac Consortium, a collaboration of clinicians, developed clinical indicators to assess care quality for acute coronary syndromes and congestive heart failure.
• Indicators were derived by expert panels to identify gaps between evidence-based practice and actual patient care.

Purpose of the Study:

• To develop and implement reliable clinical indicators for monitoring and improving the quality of care for cardiovascular conditions.
• To assess the impact of feedback and education on clinical practice and patient outcomes.

Main Methods:

• Expert panel derivation of indicators measuring evidence-practice gaps.
• Data collection from hospital records and general practice forms to calculate process and outcome indicators.
• Reliability testing (kappa scores 0.7-1.0) and clinician validation of indicators.

Main Results:

• Indicators were reported biannually to hospitals and every 10 months to general practices.
• Feedback, education, and customized analyses were provided to stimulate practice change.
• Significant improvements were observed in 17 out of 40 process indicators during the project.

Conclusions:

• The use of clinical indicators effectively supported clinicians in monitoring practice standards.
• The initiative led to positive changes in healthcare systems and clinician behavior.
• Indicator measurement is being expanded to other hospitals, with general practices exploring cost-effective audit methods.