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Vascular surgery institutional-based quality and performance measures for the care of patients with critical limb

Bjoern D Suckow1, David H Stone2

  • 1Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766.

Seminars in Vascular Surgery
|December 15, 2015
PubMed

Insights

Quality of care for critical limb ischemia (CLI) varies widely. This study proposes standardized quality metrics, including ankle-brachial index and wound healing, to improve consistency and reduce disparities in CLI treatment.

Area of Science:

  • Vascular Surgery
  • Health Services Research
  • Quality Improvement

Background:

  • Critical limb ischemia (CLI) care quality is inconsistent across different patient demographics and geographic locations.
  • Existing performance measures for peripheral vascular disease lack specificity for CLI.
  • There is no established consensus for benchmarking CLI healthcare delivery quality.

Purpose of the Study:

  • To review existing quality measures for peripheral vascular disease.
  • To propose specific, optimal quality metrics for critical limb ischemia (CLI) patient care.
  • To establish a framework for standardizing CLI care and reducing treatment disparities.

Main Methods:

  • Review of existing broad performance measures for peripheral vascular disease.
  • Identification and suggestion of relevant quality indicators for CLI.
  • Proposal of additional metrics tailored to CLI management.

Main Results:

  • Suggested optimal quality measures include ankle-brachial index, optimal medical therapy, smoking cessation, and duplex surveillance.
  • Proposed additional CLI-specific measures: diabetic management, wound healing assessment, and quality of life indicators.
  • Combination of these criteria offers a metric for standardizing CLI care.

Conclusions:

  • A standardized set of quality metrics can facilitate comparisons across institutions for critical limb ischemia (CLI) care.
  • Implementing these criteria has the potential to reduce existing disparities in CLI treatment.
  • This approach can lead to more consistent and equitable healthcare delivery for CLI patients.

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