First, do no harm. Second, do more good. Sounds simple, right? But in fact, systematically improving healthcare means figuring out how to measure quality of care.
As a healthcare organization, it can often feel like “quality of care” is in the eye of the beholder. Sure, your stakeholders probably see eye-to-eye when looking at the big picture—everyone wants effective (aka value-based) care and an efficient use of resources. Most realize that patient-centered care is critical to that goal. Different stakeholders, however, approach quality of care from different points of view.
Patients want to feel heard and respected as much as they want to feel better. Doctors and other clinicians value the right information and resources at the right time so they can make good treatment decisions. Health insurance providers are focused on financial issues, and need to balance short and long-term savings and costs. Policy makers want to see positive health outcomes across an entire community.
If you are only gathering information to address one particular section of your stakeholders, not only are you setting yourself up for a disgruntled constituency, you are also missing out on key information that can improve your processes, management, care, and outcomes.
Addressing those needs makes knowing how to measure quality of care central to your success. When success could mean life or death to the people you serve, you need a robust and focused dataset to make logical decisions.
A word of caution before we begin:
The increased use of electronic health records (EHRs) gives healthcare organizations the ability to collect and track statistics on almost every aspect of health and healthcare. It can be tempting to track everything, but smart organizations know that well-defined clinical quality measures (CQMs) are more valuable than piles of data.
There are thousands of different measurements being used to evaluate healthcare right now. The Institute of Medicine, however, highlights why this is a problem. “Although many of these measures provide useful information, their sheer number, as well as their lack of focus, consistency, and organization, limits their overall effectiveness in improving performance of the health system.”
So, faced with the daunting challenge of defining the best clinical quality measures, what metrics should your organization focus on?
Recently, a committee of the top health foundations created a streamlined list of core metrics within a four-domain framework—healthy people, care quality, lower cost, and engaged people—to provide consistent benchmarks for health progress across the nation and improve system performance in the highest-priority areas.
Depending on your organization’s focus, you’ll want to choose the ones most aligned with your activities and goals. The following categories are outlined with examples and explanations by the Institute of Medicine.
1. Life expectancy is a validated, readily available, and easily understandable measure for a critical health concept.
2. Well-being (self-reported) captures the subjective dimensions of health related to quality of life and often predicts use of and satisfaction with healthcare.
3. Overweight and obesity metrics point to causes and consequences that extend beyond the health system.
4. Addictive behavior represents a complex challenge for the health system, communities, and families.
5. Unintended pregnancy is a measure that aggregates a variety of social, behavioral, cultural, and health factors.
6. Healthy communities includes critical elements of health that fall outside the care system, such as housing, employment, and environmental factors.
7. Preventive services present a valuable opportunity for both improving health and reducing costs.
8. Care access is a critical precondition for a high quality health system.
9. Patient safety requires a culture that prioritizes and assesses safety through a reliable index of organizational results.
10. Evidence-based care is supported by scientific evidence for appropriateness and effectiveness. Aggregating carefully selected and standardized clinical measures can provide a reliable composite index of system performance.
11. Care match with patient goals ensures that the healthcare system is focusing on the aspects of care that matter most to patients.
12. Personal spending burden can limit access to care, lead people to avoid care, or prevent them from spending money in other areas of value to them.
13. Population spending burden can be measured at national, state, local, and institutional levels.
14. Individual engagement ensures individuals are aware of their options and responsibilities in caring for their own health and that of their families and communities.
15. Community engagement provides different levels of resources to support efforts to maintain and improve individual and family health.
As a healthcare organization, you answer to a variety of stakeholders. You’re concerned about making sure patients have good health outcomes and access to the right services. You’re also keenly aware of the need to provide administrators, policy makers and funders with tangible measurements of your efforts and success. Answering the question of how to measure quality of care requires you to collect, assess, and respond to well-defined CQMs.
Building your internal CQMs based on the core metrics above will make sure you can speak to the central concerns of your stakeholders with outcomes-centered data. Once you have done that, capturing, tracking, and reporting on these metrics in ways that help your organization improve can be the most challenging part. ETO Software can help you integrate these metrics into your organization’s operations and EHRs. That way, you can focus on protecting and improving the health of those you serve.