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Measuring Healthcare Quality: Composite Metrics
"Moving the Needle" on Healthcare Quality happens when: |
Quality is Clearly Defined Quality is Measured Interventions to Improve Quality are Developed and Implemented |
The Maverick point of view is that to truly "move the needle" on quality, an organization must begin by clearly defining it. While there is no standard healthcare industry definition of what constitutes "quality," we have found that top healthcare performers adopt a composite of measures that consider: |
Clinical Outcomes: Ultimately it is the outcome that matters most. Risk adjusted healthcare quality measures such as inpatient mortality rate, readmission rate, complication rate are commonly accepted indicators of quality outcome success. |
Clinical Process: Effective clinical processes are essential to achieving superior healthcare quality outcomes. At a minimum, current publicly reported "core measures" should be considered. Evidence based physician order sets and clinical care plans provide a rich assortment of additional quality process measures. |
Resource Utilization: "Too little" or "too much" care can adversely affect outcomes. Measures such as risk adjusted average length of stay, ICU ALOS, and cost per case are examples of effective resource utilization indicators. |
Top performing organizations not only define and measure healthcare quality, they ask the question: "How are we doing?" We believe that the best way to answer that question is to compare your organization's results to those of "Top Performers." There are a number of organizations that provide excellent health care industry clinical quality and financial benchmark information. Through benchmarking, organizations are able to identify their strengths and weaknesses, and develop strategies to address and overcome healthcare quality gaps. |
Benchmarked performance ratings on individual measures can then be weighted and rolled up to measure overall quality performance for individual conditions (e.g. pneumonia vs. AMI, individual hospitals within a health delivery system, or a system - wide composite score. Many Top Performers establish quality performance goals, and compensate their leaders on degree of goal achievement. |
"The quality of expectations determines the quality of our action." |
Andre Godin |