Get Measured Get Managed: Australian cardiac rehabilitation national quality indicators to measure service effectiveness

C Astley, E Thomas, R Zecchin, C Ferry, R Gallagher

Research output: Contribution to conferenceAbstractpeer-review


Background/Introduction: Comprehensive exercise ­based cardiac rehabilitation (CR) has well­ established efficacy and effectiveness for improving patient outcomes. In Australia there is substantial variability in terms of clinical effectiveness and quality measurement of CR programs which limits service improvement initiatives. In2018 a Think Tank led by the Australian Cardiovascular Health and Rehabilitation Association (ACRA) and the National Heart Foundation of Australia (NHFA) was held with agreement to develop nationally­ agreed, internationally­ consistent, locally ­relevant quality indicators.

Purpose: The purpose was to provide a minimum set of standardised national­level quality indicators (QI) that should be collected and reported on by CR programs to determine the quality of delivery and associated outcomes, benchmark performance and support improvement processes.

Methods: We formed the National Cardiac Rehabilitation Quality Indicator (NACRQI) Taskforce led by ACRA and NHFA. The National Institute for Health and Care Excellence (NICE) UK guidelines for high quality QIs were used for our process including topic overview, prioritising areas for quality improvement, drafting and consultation, validation and consistency checking.

Results: Eleven preliminary QIs were circulated for ranking and comment to all ACRA members (predominately multidisciplinary CR providers) (68 responses), and to leading national multidisciplinary CR experts from cardiology, research, physiotherapy, nursing, epidemiology and register backgrounds (7 responses). Ratings, comments and suggestions were collated and discussed by the NACRQI Taskforce, and the indicators rated most important, useful and feasible were retained, resulting in 10 QIs. These 10 QIs were presented at the ACRA national conference and then discussed at a workshop (55 participants) for this purpose. A final 10 QIs and accompanying data dictionary with definitions, evidence and allowable values is the final product.

Conclusions: A minimum set of locally relevant, internationally recognised, national QIs for CR is now available for CR providers, health service managers and researchers in Australia. While the QIs will best serve national interests when incorporated within a national cardiac registry or state­ and territory­ level registries, the QIs will also be useful for site audits and have strong potential to be aggregated across sites, health districts and states. Finally, the ultimate test of the QIs will be how useful they are for CR program coordinators and funders of such programs; a key consideration for building sustainable business models and ensuring long­ term implementation.
Original languageEnglish
Number of pages1
Publication statusPublished - 2020
EventEuroHeartCare Virtual Conference 2020 - Seville
Duration: 4 Jun 20206 Jun 2020


ConferenceEuroHeartCare Virtual Conference 2020
Internet address


  • Australian
  • Cardiac Rehabilitation
  • Service Effectiveness


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