Multistakeholder perspectives on composite measures of ambulatory care quality: a qualitative descriptive study

The development of composite measures of ambulatory care quality is an area of growing practice and policy interest. Using 29 semistructured interviews, this study describes the opinions of stakeholders related to the use and development of composite measures in a multistakeholder setting. Research experts working in multistakeholder settings need to understand the perspective of various stakeholders, many of whom have varying levels of research expertise, in order to develop useful and acceptable composite measures. Findings from this study suggest that to achieve maximal stakeholder buy-in, research experts should focus on clinical area-specific composites that are designed and constructed in a simple and transparent manner. However, composite measures are not a panacea for improving the utility of public reporting. Performance measure and report card creators should continue to investigate other ways to improve the user-friendliness of their reports and to address other barriers that prevent more extensive use of reports.