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Related Experiment Videos

Choosing and evaluating clinical performance measures

E A McGlynn1

  • 1Center for Research on Quality in Health Care, RAND Health, Santa Monica, CA 90407-2138, USA. mcglynn@rand.org

The Joint Commission Journal on Quality Improvement
|October 15, 1998
PubMed
Summary
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Externally reported quality measures for healthcare organizations must be meaningful, scientifically sound, and interpretable. Standardizing expectations and evaluation criteria will improve healthcare quality assessment.

Area of Science:

  • Health Services Research
  • Quality Improvement Science

Background:

  • Externally reported quality assessments in managed care and hospitals are widely accepted.
  • Proposers of quality measures must ensure results are meaningful, scientifically sound, and interpretable.

Purpose of the Study:

  • To outline criteria for selecting meaningful clinical performance measures.
  • To define scientific soundness and interpretability of quality measures.

Main Methods:

  • Criteria for selecting meaningful assessment areas include impact on morbidity/mortality, empirical link between process and outcomes, current quality variability, and ability to take action.
  • Scientific soundness depends on precision, adaptability, and risk adjustment.
  • Interpretability is influenced by measure content, audience, and statistical presentation.

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Main Results:

  • Meaningful measures target conditions with significant morbidity/mortality impact.
  • Empirical evidence must support the link between care processes and outcomes.
  • Quality should be variable, allowing for improvement through provider actions.

Conclusions:

  • Increased standardization of expectations for public quality measures is needed.
  • Standardized evaluation criteria will enhance the field of healthcare quality assessment.