Measuring and Improving Quality of Care A Report From the American Heart Association/American College of Cardiology First Scientific Forum on Assessment of Healthcare Quality in Cardiovascular Disease and Stroke

Quantifying and improving the quality of health care is an increasingly important goal in American medicine. To address this need, the First Scientific Forum on Assessment of Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke was held May 24 to May 26, 1999. This conference brought together providers, researchers, payers (eg, the Health Care Financing Administration [HCFA] and the US Department of Veterans Affairs [VA]), managed care, industry, and assessors of healthcare quality (eg, the Joint Commission on Accreditation of Healthcare Organizations [JCAHO], National Committee for Quality Assurance [NCQA], and Foundation in Accountability [FACCT]) to discuss the current state of quality assessment in cardiovascular disease and stroke. An important aspect of the forum was the 4 working groups that were formed to focus on acute myocardial infarction (AMI), heart failure, stroke, and methods of quality assessment and improvement. Members of the working groups are listed in the Appendix. The discussion and lectures that took place at the conference illuminated several important methodological challenges inherent in judging the quality of health care and evaluating changes in it over time. This summary highlights several of the most important topics in quality measurement. It also includes summary reports on quality measurement provided by conference working groups on AMI, heart failure, and stroke.