Measuring Quality of Care
Key Performance Indicators
Based on clinically relevant procedural outcomes, VCOR has adopted a number of key performance indicators (KPIs) to monitor and benchmark the performance of health services in their delivery of quality cardiac care. The KPIs are based on clinically relevant outcomes collected in VCOR, as determined by the Clinical Quality Committee and relevant Working Groups.
The KPIs reported for the VCOR PCI module are:
- In-hospital mortality
- In-hospital major bleeding
- Length of stay
- In-hospital unplanned revascularisation
- Door to balloon/device time for STEMI patients
- 30-day mortality
- 30-day target vessel failure
- 30-day major adverse cardiac and cerebrovascular event (MACCE)
For the first time, in 2014, VCOR has included a risk-adjustment model for the KPI, 30-day mortality. The process of risk adjustment is an essential component of reporting of patient outcomes in mature clinical quality registries. It allows data to be presented in a way that controls for variations in patient population and is a fair and more representative way of benchmarking hospitals’ relative performance.
Now that VCOR has a rich data set, more risk-adjustment models will be explored to adjust for relevant clinical factors in other patient outcomes, such as in-hospital bleeding.
Clinical Quality Review Process
The VCOR Clinical Quality Committee (CQC) review KPI data quarterly and annually. Data is reviewed for the current review period and compared against the previous quarter/year. Data are displayed in the form of funnels plots to assist the benchmarking of performance of the contributing VCOR sites. This format provides an easy way to appreciate the relationship between hospital outcomes and the number of procedures performed in each hospital.
Sites are officially notified if they flag as an outlier in any given period. No action is required unless a site flags in two or more consecutive reporting periods, or if other significant patterns are noted by the CQC.
The CQC reviews data from previous reporting periods until the data set is deemed 'complete'. This ensures that any concerning outlier patterns or variance in the quality of service provided will not be overlooked if data was incomplete at the data submission deadline for quarterly review.
The outcome of all Clinical Quality Reviews are reported up to the VCOR Steering Committee.
Sites are then provided with an individualised report displaying their current quarterly or annual results. For more information about these reports, please visit our VCOR Reporting page.