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Performance measures for pneumonia: are they valuable, and are process measures adequate?
Dale W Bratzler1, Wato Nsa, Peter M Houck
1Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma 73134, USA. dbratzler@okqio.sdps.org
Current Opinion in Infectious Diseases
|May 15, 2007
Summary
Performance measurement for pneumonia care has improved quality but may have unintended consequences. Further research is needed to link process measures to patient outcomes and ensure patient safety.
Area of Science:
- Healthcare quality measurement
- Public health initiatives
- Patient safety research
Background:
- National initiatives in the USA focus on measuring and reporting pneumonia care quality.
- Performance measures are used for public reporting and pay-for-performance to enhance provider accountability.
- Concerns exist regarding potential unintended consequences and patient harm from performance measurement and reporting.
Purpose of the Study:
- To review the impact of pneumonia care quality measurement on healthcare.
- To assess improvements in care processes and patient outcomes.
- To evaluate the relationship between process measures and patient outcomes, considering potential harms.
Main Methods:
- Review of national data on pneumonia care processes and clinical outcomes since 1999.
- Analysis of the association between improved processes of care and patient outcomes.
- Examination of concerns regarding unintended consequences of performance measurement.
Main Results:
- Substantial improvements in performance on pneumonia care process measures observed since 1999.
- Patient clinical outcomes have also improved, but the direct link to process improvements remains unclear.
- While direct evidence of harm is limited, concerns about potential direct or indirect patient harm persist.
Conclusions:
- Measuring pneumonia care processes is feasible and has accelerated quality improvement.
- There is an ongoing need for outcome-focused quality measures for pneumonia, including care transitions and efficiency.
- Continuous re-evaluation of process measures is necessary to ensure alignment with desired patient outcomes.
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