Each writing group member participated in the development of at least 2 draft performance measures. Subsequent teleconferences were held in which each of these drafts was reviewed by the writ- ing group with input designed to improve the measurement set specifications before voting by the writing group. During these teleconferences, existing performance measures from other organizations as described previously were reviewed with special attention given to NQF-endorsed measures. Draft measurement set specifications were revised when deemed appropriate in order to harmonize with existing measures. Each measure was then voted on for inclusion or exclu- sion with a standardized ballot form that included a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree) on various aspects concerning suitability for submission as a performance measure. The ballots allowed measures to be rated separately on these various dimensions: evidence-based, inter- pretable, actionable, design of numerator and denominator, reli- ability, validity, and feasibility for implementation, as well as an overall assessment. Ballots were then reviewed and discussed on follow-up conference calls for consensus among the writing group for ultimate inclusion in the performance measure set. Review and Endorsement In February 2017, the ICH performance measures document underwent a 30-day public comment period, during which AHA members and other healthcare professionals had an opportunity to review and comment on the measurement set specifications for each of the 9 specific performance measures proposed. Relevant healthcare organizations and professional societies were alerted to the publication of the document and encouraged to comment. Numerous comments were received, which were reviewed by the writing group via e-mail and in teleconference to determine whether changes to a specific measure should be made. When deemed appropriate, these changes were made before the development of this final manuscript describing the ICH performance measures. 