Chief complaint-based performance measures: a new focus for acute care quality measurement

Ann Emerg Med. 2015 Apr;65(4):387-95. doi: 10.1016/j.annemergmed.2014.07.453. Epub 2014 Oct 16.

Abstract

Performance measures are increasingly important to guide meaningful quality improvement efforts and value-based reimbursement. Populations included in most current hospital performance measures are defined by recorded diagnoses using International Classification of Diseases, Ninth Revision codes in administrative claims data. Although the diagnosis-centric approach allows the assessment of disease-specific quality, it fails to measure one of the primary functions of emergency department (ED) care, which involves diagnosing, risk stratifying, and treating patients' potentially life-threatening conditions according to symptoms (ie, chief complaints). In this article, we propose chief complaint-based quality measures as a means to enhance the evaluation of quality and value in emergency care. We discuss the potential benefits of chief complaint-based measures, describe opportunities to mitigate challenges, propose an example measure set, and present several recommendations to advance this paradigm in ED-based performance measurement.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Chest Pain / diagnosis
  • Chest Pain / epidemiology
  • Chest Pain / therapy
  • Emergency Medical Services / standards*
  • Humans
  • Quality Assurance, Health Care / methods*
  • Quality Improvement
  • Quality Indicators, Health Care