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Metric-driven harm: an exploration of unintended consequences of performance measurement
Betty Rambur1, Carol Vallett, Judith A Cohen
1University of Vermont, College of Nursing and Health Sciences, Burlington, VT 05405, USA.
Abstract:
Performance measurement is an increasingly common element of the US health care system. Typically a proxy for high quality outcomes, there has been little systematic investigation of the potential negative unintended consequences of performance metrics, including metric-driven harm. This case study details an incidence of post-surgical metric-driven harm and offers Smith's 1995 work and a patient centered, context sensitive metric model for potential adoption by nurse researchers and clinicians. Implications for further research are discussed.
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