Conceptual approach to developing quality measures for transgender patients

Adam J Rose,Guneet K Jasuja,Michael S Dunbar,Jaclyn M W Hughto

doi:10.1186/s12913-021-06161-5

Abstract

BackgroundValid and reliable quality measures can help catalyze improvements in health care. The care of transgender patients is ripe for quality measurement, as there is increasing awareness of the increasing prevalence of this population and the urgency of improving the health care they receive. While best practices may not exist for some aspects of transgender health care, other aspects are characterized by well-developed and highly evidence-based recommendations. Our objective was to create a list of potential quality measures for transgender care.Methods and resultsIn consultation with our advisory panel, which consisted of clinical and academic experts in transgender medicine, we selected eight prominent clinical practice guidelines of transgender health care for review. Our four team investigators carefully reviewed all eight clinical practice guidelines. Through the course of multiple consensus-building meetings, we iteratively refined items until we had agreed upon a list of forty potential quality measures, all of which met the criteria for quality measures set forth in the Center for Medicare and Medicaid Services Blueprint for developing quality measures.ConclusionsThis manuscript explains the origin of the quality measures we developed, and also provides a useful roadmap to any group hoping to develop quality measures for a field that has not previously had any.

Highlights

Valid and reliable quality measures can help catalyze improvements in health care
How do we develop quality measures? Quality Measure (QM) development is guided by a standardized approach, as set forth by the Centers for Medicare and Medicaid Services (CMS) Blueprint for Measure Development and Management [26]
Review of clinical practice guidelines Care recommended as part of clinical practice guidelines (CPGs) may not always be suitable for direct adoption as quality measures, unless careful thought is given to how best to adapt them to this purpose [29]

Summary

Introduction

Valid and reliable quality measures can help catalyze improvements in health care. The care of transgender patients is ripe for quality measurement, as there is increasing awareness of the increasing prevalence of this population and the urgency of improving the health care they receive. Our objective was to create a list of potential quality measures for transgender care. Since the 1980s, a steadily improving science and practice of quality measurement has driven remarkable improvements in the quality of care in a wide array of clinical domains [4]. The care of transgender patients is one of these areas. Implementing valid QMs can serve as a basis for improving care in a clinical area or population that previously lacked them [5, 8]. In light of the NAM call for research to advance the health of transgender patients [9]; we aimed to conduct research to identify candidate QMs for transgender care

Objectives

Methods

Results

Discussion

Conclusion