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Summary
Public reporting on hospital quality is increasing, but consensus on measure design is lacking. Differentiating between internal quality improvement and external accountability measures is crucial for effective healthcare performance measurement.
Area of Science:
- Healthcare Performance Measurement
- Health Services Research
Background:
- Growing demand for public reporting on hospital quality from various entities.
- Development and testing of numerous healthcare quality measures are underway.
- Lack of consensus regarding the appropriate form and function of healthcare quality measures.
Discussion:
- Healthcare quality measures possess both a subject (process or outcome) and a function (improvement or accountability).
- Quality improvement measures are detailed, for internal use, and support continuous enhancement.
- Accountability measures are concise, for external use (e.g., 'report cards'), and reported at the hospital or clinic level.
Key Insights:
- Distinguishing between internal quality improvement and external accountability functions is essential.
- Measures should be tailored to their specific function and target audience.
- Clear definitions of measure subject (process vs. outcome) and function are needed.
Outlook:
- Future development of healthcare quality measures requires careful consideration of their intended use.
- Standardization of measure development and reporting can enhance comparability and utility.
- Addressing the consensus gap will improve the effectiveness of public reporting and quality initiatives.