Ensuring Quality in the Cardiac Cath Lab

Who defines quality in the cardiac cath lab?

Let’s first look at the definition of “quality.” Quality, according to Merriam-Webster’s dictionary, is the standard of something as measured against other things of a similar kind; the degree of excellence of something. Quality is hard to define because it depends on one’s perspective. It is a singular judgment for all of our customers: patients, expert clinicians, administrators, payers, cardiac cath lab (CCL) team members, patients, and their family and loved ones. Expert clinicians say quality is measured by outcomes, but success is often a matter of perspective. Administrators equate quality to return on investment (ROI) and payers look to metrics like Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) to benchmark against national averages, possibly measuring against faulty data. A CCL team might judge quality through specific metrics and standards such as the American College of Cardiology’s National Cardiovascular Data Registry (ACC-NCDR) database. Finally, a patient’s family might judge quality based on how well the staff kept the family informed. As a patient, quality could be perceived by the staff caring for you as an individual.

The determination of successfully meeting quality metrics in the CCL is complicated and ever changing. In a pay-for-performance health care model, the insistence of transparency of process and third-party validation is an unequivocal reality. Noting that systems of care are increasingly complex, Dr. Babb states, “…it becomes a challenge for all of us to practice at the highest level while keeping up with expert opinion and evidence-based guidelines.”