Abstract
Zegers and colleagues’ study codifies the perceived burden of quality monitoring and improvement stemming from the work by clinicians of registering (documenting) quality information in the medical record. We agree with Zegers and colleagues’ recommendation that a smaller, more effective and curated set of measures is needed to reduce burden, confusion, and expense. We further note that focusing on validity of clinical evidence behind individual measures is critical, but insufficient. We therefore extend Zegers and colleagues’ work through a pragmatic, tripartite heuristic. To assess the value of and curate a targeted set of performance measures, we propose concentrating on the relationships among three factors: (1) The purpose of the performance measure, (2) the subject being evaluated, and (3) the consumer using information for decision-making. Our proposed tripartite framework lays the groundwork for executing the evidence-based recommendations proposed by Zegers et al, and provides a path forward for more effective healthcare performance-measurement systems.
Highlights
Performance measurement and quality monitoring are ubiquitous in healthcare
Zegers and colleagues[2] contribute to the quality measurement literature by codifying and quantifying what healthcare professionals experience every day: the palpable burden of quality performance measurement. as described in their findings, clinicians perceived the number of measures and the time required to document them in the medical record as excessive, and quality improvemen registration was perceived as taking time away from the patient experience
Faced with what feels like an excessive burden, clinicians and patients often suffer unintended consequences from quality measurement: clinicians struggle to prioritize among competing qualityimprovement initiatives, and patients become confused when making informed health decisions.[3,4,5]
Summary
Description Linking organizational goals with individual goals, to reinforce behaviors consistent with organizational goals. Making between-provider or between-organization comparisons to make administrative decisions such as selection, termination, merit increases
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