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

On the plus side process measures can be used to

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Unformatted text preview: pply broadly to all process measures compared with outcomes (Table 1). On the plus side, process measures can be used to provide feedback for quality improvement initiatives. Because many factors can influence patient outcomes, process measures have the potential to identify for clinicians exactly which processes they followed or didn’t follow that had the potential to affect patient outcomes. Process measures provide information that is actionable; i.e. what is being done well and what needs improvement. When process measures are developed well, so that they accurately reflect the care that clinicians are delivering, clinicians feel accountable for them. In contrast, many other factors affect health care outcomes that are beyond the provider’s control. When a clinician discovers that his patient had worse outcomes than another clinician’s patients, it is unclear what he or she should be doing about it. When data collection about process of care is generated unobtrusively simply by an electronic patient record when a provider performs the process, these measures become even more attractive and feasible because they eliminate burdensome additional data collection. Secondly, most process measures require less risk adjustment for patient illness than do most outcome measures. The use of a process measure requires defining a population that is eligible to receive the process such as which patients with asthma should receive anti-inflammatory medications or which patients should receive beta-blockers or aspirin after myocardial infarction. Once the eligible population is specified, further risk adjustment is generally not required, although it can be useful. In contrast, comparing mortality rates or other outcomes for specific clinical conditions requires risk adjustment. Risk adjustment requires definition and measurement of many patient characteristics, including physiological, anatomical, and health status data that are not part of routine administrative...
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