Vascular surgery institutional-based quality and performance measures for the care of patients with critical limb ischemia

The intensity and quality of medical care provided to patients with critical limb ischemia (CLI) varies by geography, ethnicity, and socioeconomic status. Although vascular surgery societal performance goals have been set forth, no consensus criteria exist by which to benchmark the quality of health care delivery specifically for CLI patients. We review existing broad performance measures for patients with peripheral vascular disease and suggest those with optimal care delivery suited for CLI (eg, ankle-brachial index, optimal medical therapy, smoking cessation, and duplex surveillance). Further, we propose that diabetic management, degree of wound healing, and quality of life measures be considered as additional quality measures for CLI management. In combination, these criteria provide a simple yet powerful metric that might allow for standardization of CLI care and comparisons across institutions, with the potential for diminishing the disparity that exists in current treatment practices.