• Richard T Griffey, Jesse M Pines, Heather L Farley, Michael P Phelan, Christopher Beach, Jeremiah D Schuur, and Arjun K Venkatesh.
• Division of Emergency Medicine and Institute for Public Health, Washington University School of Medicine, St. Louis, MO. Electronic address: griffeyr@wustl.edu.
• Ann Emerg Med. 2015 Apr 1; 65 (4): 387-95.

AbstractPerformance 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.Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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