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PhD 3743: Current State of Performance Measurement in Health Care,…
PhD 3743: Current State of Performance Measurement in Health Care, 10/28/2017
1 Abstract
Healthcare quality measurement is 250 years
Evokes anxiety and frustration
Documented care improvements; not sure on decision making
2 Various Perspectives
Professional Perspective
Not of much practical use
Not worth the cost benefit
Easiest/cheapest measures are least important for QI
Public Policy Perspective
Should be integral to everyday care
Major drivers- evidence for quality, demand for accountability
Evidence required by stakeholders
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3 Essential History
Eras
1850-1917: Industrial revolution and scientific management
1915-1935: bureaucracies and organizations
1935-1960: HR, stat control, expansion of health care
1960-1980: status quo
1980 to present: quality health organization
Dr. Earnest A Codman, Massachusetts General Hospital
Physician who advocated for "End Results"
Avedis Donabedian, Outcomes Research
structure: characteristics associated with health care
process: what is done in health care setting
outcome: ultimate status of patient after interventions
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9 The Future
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Measurements add cost, but need to show tangible improvements and data-driven decisino making