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

References 1 marshall m shekelle p brook r leatherman

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Unformatted text preview: wed for various uses of process of care measures for internal quality improvement, for choice of providers by patients or purchasers, and for accreditation and regulatory purposes. References 1. Marshall M, Shekelle P, Brook R, Leatherman S. Dying to Know: Public Disclosure of Information about the Quality of Care. Santa Monica, CA and London, UK: The Nuffield Trust and RAND, 2000. For an accreditation or regulatory audience, summary measures for the relevant unit of analysis are helpful. For example, in the US an organization such as the NCQA that accredits health plans will use health plans as the unit of analysis. These groups generally present summary measures and the measures must be strongly linked to outcomes. For these uses, acceptance by the clinical community is also important, and providers often assist in the development of the accreditation policies. Finally, the burden on clinicians to collect and analyze the data must be low, as results are not used for direct clinical feedback. Unfunded mandates can place an increased burden on a taxed health care system, potentially mitigating the benefits of assessing quality. 2. Miller T, Leatherman S. The National Quality Forum: a ‘metoo’ or a breakthrough in quality measurement and reporting? Health Aff (Millwood) 1999; 18: 233–237. Conclusion 7. Palmer RH. Process based measures of quality: the need for detailed clinical data in large health care databases. Ann Intern Med 1997; 127: 733–738. In this essay, we have discussed the advantages and disadvantages of process measures of quality, and some strategies for implementing them for different purposes or audiences. Process measures are highly acceptable to providers because they demonstrate clearly how providers can improve their outcomes. Clinicians are also more accountable for the process of care than its outcomes, which are affected by many other things. As electronic medical records become more common, process measures can be unobtrusively tracked as part of routine clinical care, which will aid in their implementation. Process measures that are incorporat...
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