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Related Experiment Videos

Connections between quality measurement and improvement.

Donald M Berwick1, Brent James, Molly Joel Coye

  • 1Institute for Healthcare Improvement, Boston, Massachusetts 02215, USA. dberwick@ihi.org

Medical Care
|January 25, 2003
PubMed
Summary

Quality measurement is essential but not enough for healthcare improvement. Barriers exist in using data for provider selection and in the capacity for care delivery change, hindering progress in the national quality measurement and reporting system.

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Area of Science:

  • Healthcare Quality Improvement
  • Health Services Research
  • Health Informatics

Background:

  • Measurement is a prerequisite for quality improvement but not sufficient on its own.
  • The national quality measurement and reporting system (NQMRS) aims to enhance healthcare quality.
  • Understanding the link between measurement and improvement is crucial for effective NQMRS design.

Purpose of the Study:

  • To categorize measurement use in improvement into two distinct pathways: selection and change in care delivery.
  • To identify barriers within each pathway that impede quality improvement.
  • To propose steps for motivating improvement across both identified pathways.

Main Methods:

  • A descriptive and conceptual discussion approach was employed.

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  • Analysis focused on the relationship between measurement, barriers, and improvement strategies.
  • Conceptual frameworks were used to classify approaches to measurement in quality improvement.

    • Main Results:

    • Pathway I (selection) barriers include lack of skill, knowledge, and motivation in using data for provider choice.
    • Pathway II (change in care delivery) barriers involve deficiencies in organizational and professional capacity for leading change.
    • Both pathways face significant hurdles beyond just measurement uniformity.

    Conclusions:

    • Current selection and improvement dynamics are unreliable.
    • Barriers extend beyond measurement issues to include a lack of capacity among organizations and individuals.
    • Addressing these capacity deficits is critical for advancing healthcare quality improvement through measurement.