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

Richard T. Griffey, Jesse M. Pines, Heather L. Farley, Michael P. Phelan, Christopher Beach, Jeremiah D. Schuur, Arjun K. Venkatesh

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


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.

Original languageEnglish
Pages (from-to)387-395
Number of pages9
JournalAnnals of emergency medicine
Issue number4
StatePublished - Apr 1 2015


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