Int J Qual Health Care-2001-Rubin-469-74

In addition a provider may adhere well to one part of

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Unformatted text preview: ss. Thus, use of certain processes as indicators of care may be dictated by availability of data, rather than the relative importance of the element of care. In addition, a provider may adhere well to one part of the process but not to another. Therefore, if process measures are not comprehensive and do not cover all the important parts of the process that can affect outcomes, they may be misleading to users. Practical strategies for developing quality measures As we have discussed previously, the audience for and use of the quality measure will influence how the measure is developed and how the results are presented. Quality measures are in general used by provider or care management organizations to evaluate and enhance performance through quality improvement initiatives, by purchasers and patients to inform health care decision making, or by accreditors and regulators to monitor organizations. Internal quality improvement initiatives For internal organizational quality improvement initiatives, more detailed, less aggregated measures of quality may be more helpful than summary measures. Providers want information regarding how to improve specific processes. As such, the unit of analysis for these initiatives tends to be small, such as the individual unit, practice, or clinician. These types of measure often require significant technical detail. An important consideration in these types of measure is that clinicians believe that the process is related to the outcome such that improvement in the process will result in improvement in outcomes. Without this belief, it is often necessary to establish the link between process and outcome. Data collection for quality improvement can be made part of routine care by existing staff and thus marginal costs are minimal. Electronic medical record systems play a very important role here, and whenever possible, quality assessment efforts should attempt to obtain needed data by replacing usual clinical data collection with collection of standardized data elements. Finally, when used internally for quality improvemen...
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