Number of patients discharged from the hospital after qualifying event/diagnosis, who are referred to CR, and who begin CR participation ≤21 days after hospital discharge* Referral is defined as: 1. Documented communication† between the healthcare provider and the patient to recommend an outpatient CR program AND 2. Official referral order‡ is sent to outpatient CR program *Day 0 is considered to be the day of hospital discharge. †All communications must maintain appropriate confidentiality as outlined by the 1996 Health Insurance Portability and Accountability Act [HIPAA]. ‡All patient information required for enrolment should be transmitted to the CR program. Necessary patient information may be found in the hospital discharge summary. Note: If a patient has had multiple qualifying events, at least 1 referral made in the past 12 months should be captured.

Number of patients discharged from the hospital after qualifying event/diagnosis including: MI, PCI, CABG, heart valve surgery/repair and/or heart transplantation, who are referred to CR, and who begin CR participation (at least 1 billed CR session)

Denominator Exclusions: Patients age <18 years Patients who leave against medical advice. Denominator Exceptions: Documentation of a patient-oriented reason that precludes CR participation after the patient has enrolled (e.g., patient moves to a new location that requires >60 minutes travel time to arrive at the enrolling CR program) Documentation of a medical reason that precludes CR participation after the patient has enrolled (e.g., patient deemed by a medical provider to have a medically unstable, life-threatening condition or has other cognitive or physical impairments that preclude CR participation) Documentation of a healthcare system reason that precludes CR participation after the patient has enrolled (e.g., patient is admitted to a nursing care or long-term care facility, or patient loses medical coverage for CR).

Data Sources: Medical record or other database (e.g., administrative, clinical, registry).

Measurement Period: Encounter

Thomas RJ, Balady G, Banka G, Beckie TM, Chiu J, Gokak S, et al. 2018 ACC/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circulation: Cardiovascular Quality and Outcomes. 2018;11(4):e000037.

Appendix A. www.ahajournals.org/doi/10.1161/hcq.0000000000000037