Cardiovascular Data Definitions and Quality
Indicators – A BRIDGE to better manage care
Paul Dorian, M.D., M.Sc., F.R.C.P.(C)
Chair, BRIDGE - Benchmarks, Research, Innovation and Data Generate Excellence in Cardiovascular Care
Director, Division of Cardiology, University of Toronto
Presentation to the Royal College
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December 9th 2014
Leadership. Knowledge. Community.
Introduction
Canadian Heart Health Strategy and Action Plan (2009):
Build the infrastructure to enable better cardiovascular health care.
Public Health Agency of Canada grant:
To establish
Cardiovascular Data Definitions (A): The establishment of panCanadian Data Dictionary to reflect national consensus on definition
with in three spheres of cardiovascular disease treatment
Cardiovascular Quality Indicators (B): Establish a national ecatalogue/repository of quality indicators both existing and new, that
would be embedded within the CCS clinical practice guidelines
process.
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This has been very successful
Leadership. Knowledge. Community.
Commonwealth Fund
How does Canada rate on Quality?
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Leadership. Knowledge. Community.
Measuring Quality of Care:
How are we doing?
Measurement plays an important part in
improvement and helps to promote change
Campbell et al.
Qual Saf Health Care 2002;11:358-364
Variation
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Standardisation
Leadership. Knowledge. Community.
Communications Strategy
Project has transitioned to BRIDGE:
Benchmarking, Research, Innovation and Data Generate Excellence
http://bridge.ccs.ca/index.php/en/
The website includes:
-Documentation arising from the project
-Project updates and news
-Platform for web consultations
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Leadership. Knowledge. Community.
Working with partners
1. Provinces
 Quality Councils
2. CCS Affiliates
3. CIHI
4. Conference Board of Canada
 Project mangement
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Leadership. Knowledge. Community.
Working Group Progress Chart — BRIDGE
October 2014
Phrase
Form Quality
Data
Web
Actions from Approval and
group indicators definitions consult web consult web posting
Scoping
Knowledge
survey/Pilot translation
measurement strategy
Core elements
P
NA
P
NA
NA
NA
NA
NA
Atrial fibrillation/flutter
P
P
P
P
P
P
P
in progress
Heart failure
Cardiac rehabilitation/secondary
prevention
P
P
P
P
P
P
P
in progress
P
P
in progress
P
P
P
P
P
Coronary angiography/revascularization
P
P
Acute coronary syndrome
P
P
Cardiacy surgery
Percutaneious coronary intervention
(PCI)
Transcatheter aortic valve implantation
(TAVI)
P
P
in progress
P
P
in progress
P
P
in progress
• Data Definition chapters linked to CIHI website and BRIDGE website.
• Five Quality Indicators preparing for peer reviewed publication.
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Leadership. Knowledge. Community.
Next phase of the project
1.
Field testing – good start. Admin databases had some of the indicators
but still need to work with other means of obtaining “granular” data.
2.
There are links to other CCS projects
3.
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a)
Choosing Wisely Canada – appropriateness
b)
Clinical Practice Guidelines
Next phase of the project will work on developing links with the provinces
and other national organizations so that the infrastructure to obtain the
data in the QI’s are developed, and cardiovascular quality indicators are
integrated into reporting and health care system management.
Leadership. Knowledge. Community.
Summary
1.
Progress Made
a.
Expanded the number of cardiovascular quality indicators
based on clinical need as well as demand from the provinces.
b.
Expanded the number of collaborators (provinces, Quality
Councils, Accreditation Canada) to ensure that the quality
indicators result in real, measurable change.
• Goal: not to measure variation but to incentive
change –through reporting– in clinical practice.
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HealthPolicyWORKs
Inc
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Leadership. Knowledge. Community.