Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Definitions and framework for assessing quality
What is known about health care quality
Slide content:Ideal Quality Measures Quality measures should be (Landon et al., 2003): Evidence-based Agreed-on standards for satisfactory performance Standardized specifications Adequate sample size for reliable estimates Adjustment for confounding patient factors Care attributable to individual physician Feasible to collect Representative of activities of specialty In God we trust, all others bring data W. Edwards Deming, statistician (19001993) Adage from business management: An organization can t improve what it cannot measure 8
Slide notes:So to assess quality, quality must be measured. Landon advocates that quality measures should be based on the best evidence for health care delivery. There should be agreed-upon standards for satisfactory performance by clinicians. There should be standardized specifications so that clinicians know what to expect and so that performance can be compared across different departments or institutions. There should be an adequate sample size to achieve reliable estimates of the quality. There should be some mechanism to adjust for confounding patient factors such as comorbidity, the number of coexisting illnesses, and socioeconomic status. There should be measures that can be attributed to individual physicians or other practitioners. It must be feasible to collect these measures, and the measures should be representative of the activities of the specialtyperhaps not everything the specialty does but a good representative sample of different things that physicians in a specific specialty do. Another point to remember about quality measures is that they have to consist of data. W. Edwards Deming, a famous statistician, said, In God we trustall others bring data, which means that all humans need to bring data to measure quality and act on it. Another adage from business management is that organizations cannot improve what they cannot measure. 8