How Will You Know You’re Making a Difference? Collecting Data and Devising Metrics

Introduction

Data collection, analysis, and presentation are key to the success of any hospital quality improvement initiative around ACS, enabling the ACS management team to track improvements in processes and outcomes for effective ACS patient management, to make necessary changes to their quality improvement efforts, and to provide administrative personnel with financial justification for their time and labor. This section discusses the underlying key principles of data collection, analysis, and reporting. The section on collecting data and devising metrics presents an overview of this rapidly evolving field as compiled from a number of groups actively working in this area and the relatively few published reports of this work from the medical literature.

It is the intent of the SHM Acute Coronary Syndrome Advisory Board to provide a practical approach to data collection and measurement of the quality of inpatient ACS management and to provide guid­ance for more uniform reporting of ACS metrics in the literature. The metrics should be considered in at least 2 and possibly 3 domains. Consider using metrics that address structures, such as, does your facility have an integrated team to provide rapid assessment and initiation of the cardiac catheterization lab? Process measures will be a key aspect of assessing any improvements you are making. For instance, using door to balloon time can be used as a measure of the process of that integrated team’s success in rapidly getting a patient to the cath lab. Finally, you will want to consider important outcomes in the areas of intervention. For patients requiring emergent catheterization, mortality may be an important outcome measure to assess.