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Terms of Reference
Aotearoa New Zealand All Cardiology Services Quality Improvement (ANZACS-QI) Data Governance Group document.
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Programme Methodology
ANZACS-QI Programme Methodology: How Cardiology Data is Collected, Protected and Used for Quality Improvement
Programme
Methodology
ANZACS-QI Programme Methodology: How Cardiology Data is Collected, Protected and Used for Quality Improvement.
How the ANZACS-QI Registry Works
ANZACS-QI is a secure, web-based cardiology clinical registry that captures data on all cardiac events and cardiology services in Aotearoa New Zealand. This information supports quality improvement, equity, and cardiovascular research, helping ensure that patients nationwide receive evidence-based treatment.
Our methodology includes a rigorous national auditing process. Dedicated coordinators regularly check the accuracy of data collection at hospitals across New Zealand. This ensures that registry data is reliable, enabling clinicians, researchers, and policymakers to:
• Monitor and improve cardiac care
• Develop clinical guidelines
• Publish high-quality research
• Track outcomes and inequities
The programme is reviewed and approved annually by the New Zealand Health and Disabilities Ethics Committee (MEC07/19/EXP), ensuring strong governance and patient protection.
Registration
Patients are entered into the ANZACS-QI registry when they are admitted to hospital with a cardiological condition.
Data record
The clinical information recorded is available for the clinician providing patient care, to improve patient care quality.
Quality improvement
A de-identified copy of the registry information is linked with routine information that is captured by the Ministry of Health and is used for quality improvement to inform national research.
Data privacy
The ANZACS-QI and VAREANZ Data Governance Groups ensure that patient data housed within the registry is gathered, managed and used appropriately to ensure patient privacy.
How ANZACS-QI Data is Used
The ANZACS-QI programme securely collects and links patient data from across Aotearoa New Zealand’s cardiology services. Information from registry cohorts (ACS–CathPCI, device, and heart failure) is combined with national administrative datasets and encrypted under Māori data sovereignty governance.
This linked data is used for:
Quality improvement in cardiology care
Audits to monitor data accuracy and outcomes
Research and registry trials with separate ethics approval
Programme Flowchart
The diagram below shows how patient data flows through the ANZACS-QI system. It illustrates how registry data is securely collected, encrypted, linked with routine Ministry of Health datasets, and then used for quality improvement, audits, and research.
Registry Trials
As shown in the flowchart above, registry trials are a key research pathway in ANZACS-QI. These clinical studies use registry data to evaluate new treatments, monitor outcomes, and generate evidence to guide cardiology practice.
Registry trials:
Require independent ethics approval
Use NHI-encrypted data to protect patient privacy
Are securely governed under Māori data sovereignty and ANZACS-QI protocols
Can link registry data with Ministry of Health datasets to create powerful, population-level insights
Want to access ANZACS-QI data for research or clinical trials?
If you are a health professional and would like to gain access to ANZACS-QI data for a clinical trial, please follow the steps below.
Learn about each step of the process
ANZACS-QI's distinctive approach includes a rigorous data auditing process, with national coordinators regularly assessing the accuracy of data collection at hospitals nationwide. This ensures the robustness and reliability of our data, which forms the basis of clinician recommendations and publications aimed at enhancing patient care and outcomes.
This programme has been approved by the NZ Health and Disabilities Ethics committee ((MEC07/19/EXP) with annual re-approval).
Registration
Patients are entered into the ANZACS-QI registry when they are admitted to hospital with a cardiological condition.
Data record
The clinical information recorded is available for the clinician providing patient care, to improve patient care quality.
Quality improvement
A de-identified copy of the registry information is linked with routine information that is captured by the Ministry of Health and is used for quality improvement to inform national research.
Data privacy
The ANZACS-QI and VAREANZ Data Governance Groups ensure that patient data housed within the registry is gathered, managed and used appropriately to ensure patient privacy.
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If you are a Health Professional and would like to gain access to ANZACS-QI data for a clinical trial, please read the DAP Data Access & Publishing Guide and complete the Data Access Proposal Request Form and send it to anzacsqi@nihi.auckland.ac.nz.
National Indicators for Quality Improvement
ANZACS-QI have set these indicators, which have been endorsed by the National Cardiac Network and the Ministry of Health. They are nationwide key performance indicators (KPIs) for the purpose of quality improvement of cardiac service delivery.
For a complete and detailed description of these indicators, please see
ANZACS-QI National Indicators and Targets May 2024
Acute Coronary Syndrome Clinical Indicators
These indicators capture the three pillars of ACS management - timely intervention, cardiac function assessment, and use of prevention medications.
Door to Cath wait time
Door to Cath within 3 days for ≥70% of ACS patients undergoing coronary angiogram.
ACS LVEF assessment
≥85% of ACS patients who undergo coronary angiogram have pre-discharge assessment of Left Ventricular Ejection Fraction (LVEF).
Composite Post ACS Secondary Prevention Medication Indicator
In the absence of a documented contraindication/intolerance ≥85% of ACS patients who undergo coronary angiogram should be prescribed guideline medications at discharge.
Vascular Access
≥85% of patients who undergo a coronary angiogram should be studied via the radial artery.
STEMI Symptom Onset to FMC
Symptom onset to first medical contact ≤60 min for STEMI patients. No target is set.
STEMI FMC (ambulance call) to Device
First medical contact (call to ambulance service) to Device (Primary PCI intervention) ≤140 minutes. No target set.
STEMI FMC (ambulance call) to Needle
First medical contact (call to ambulance service) to Needle (Fibrinolysis) ≤60 minutes. No target set.
Cardiac Implantable Device Clinical Indicators
These indicators track the timely implantation of pacemakers (PPMs) and implantable cardiac defibrillators (ICDs).
Pacemaker in-patient wait time
≥70% of in-patients referred for a new PPM should be implanted within three days of admission to hospital.
Implantable Cardiac Defibrillator wait time
≥70% of in-patients referred for a new ICD should be implanted within three days of acceptance onto the waitlist.
Heart Failure Clinical Indicators
HF LVEF assessment
≥85% of patients hospitalised with acute decompensated heart failure have LVEF assessment within two years of index hospitalisation.
Composite HFrEF Medication Indicator
Proportion of patients with heart failure with reduced ejection fraction (HFrEF) who were prescribed (or have documented contraindication/intolerance to) all four pillars of guideline directed medical therapy on discharge (i) ACEi/ARB/ARNI, (ii) beta-blocker, (iii) mineralocorticoid antagonist, (iv) SGLT2 inhibitor.
Registry Data Completion Indicators
ACS Registry completion
≥95% of patients presenting with Acute Coronary Syndrome who undergo coronary angiography have completion of ANZACS-QI ACS and Cath/PCI registry data collection within 30 days of discharge and ≥99% within three months.
Device Registry completion
≥99% of patients who have pacemaker (PPM) or implantable cardiac defibrillator (ICD) implantation/replacement have completion of ANZACS-QI Device PPM and ICD forms within two months of the procedure.
HF Registry completion
≥95% of patients who have been identified in the sample of heart failure hospitalisations, have completion of the ANZACS-QI Heart Failure registry form within nine months of hospital discharge.
National Indicators for Quality Improvement
ANZACS-QI have set these indicators, which have been endorsed by the National Cardiac Network and the Ministry of Health. They are nationwide key performance indicators (KPIs) for the purpose of quality improvement of cardiac service delivery.
For a complete and detailed description of these indicators, please see ANZACS-QI National Indicators and Targets May 2024
Acute Coronary Syndrome Clinical Indicators
These indicators capture the three pillars of ACS management - timely intervention, cardiac function assessment, and use of prevention medications.
Door to Cath wait time
Door to Cath within 3 days for ≥70% of ACS patients undergoing coronary angiogram.
ACS LVEF assessment
≥85% of ACS patients who undergo coronary angiogram have pre-discharge assessment of Left Ventricular Ejection Fraction (LVEF).
Composite Post ACS Secondary Prevention Medication Indicator
In the absence of a documented contraindication/intolerance ≥ 85% of ACS patients who undergo coronary angiogram should be prescribed guideline medications at discharge.
Vascular Access
≥85% of patients who undergo a coronary angiogram should be studied via the radial artery.
STEMI Symptom Onset to FMC
Symptom onset to first medical contact ≤60 min for STEMI patients. No target is set.
STEMI FMC (ambulance call) to Device
First medical contact (call to ambulance service) to Device (Primary PCI intervention) ≤140 minutes. No target set.
STEMI FMC (ambulance call) to Needle
First medical contact (call to ambulance service) to Needle (Fibrinolysis) ≤60 minutes. No target set.
Cardiac Implantable Device Clinical Indicators
These indicators track the timely implantation of pacemakers (PPMs) and implantable cardiac defibrillators (ICDs).
Pacemaker in-patient wait time
≥70% of in-patients referred for a new PPM should be implanted within three days of admission to hospital.
Implantable Cardiac Defibrillator wait time
≥70% of in-patients referred for a new ICD should be implanted within three days of acceptance onto the waitlist.
Heart Failure Clinical Indicators
HF LVEF assessment
≥85% of patients hospitalised with acute decompensated heart failure have LVEF assessment within two years of index hospitalisation.
Composite HFrEF Medication Indicator
Proportion of patients with heart failure with reduced ejection fraction (HFrEF) who were prescribed (or have documented contraindication/intolerance to) all four pillars of guideline directed medical therapy on discharge (i) ACEi/ARB/ARNI, (ii) beta-blocker, (iii) mineralocorticoid antagonist, (iv) SGLT2 inhibitor.
Registry Data Completion Indicators
These indicators track the timely implantation of pacemakers (PPMs) and implantable cardiac defibrillators (ICDs).
ACS Registry completion
≥95% of patients presenting with Acute Coronary Syndrome who undergo coronary angiography have completion of ANZACS-QI ACS and Cath/PCI registry data collection within 30 days of discharge and ≥99% within three months.
Device Registry completion
≥99% of patients who have pacemaker (PPM) or implantable cardiac defibrillator (ICD) implantation/replacement have completion of ANZACS-QI Device PPM and ICD forms within two months of the procedure.
HF Registry completion
≥95% of patients who have been identified in the sample of heart failure hospitalisations, have completion of the ANZACS-QI Heart Failure registry form within nine months of hospital discharge.
Related Resources
Related Resources
Explore key documents that support the ANZACS-QI programme methodology. For the full collection, visit our Resources pages.
