Analysis & commentary: A road map for improving the performance of performance measures.

The desire to improve the quality of health care has prompted the increased use of performance measures. These measures examine the outcomes of interventions for evidence of improved health and are used to hold providers accountable for the quality of health care. Yet tension exists regarding the capabilities of the current science of quality measurement. Physicians and researchers often question the validity of these data-for example, the use of hospital claims to measure quality-even as policy makers, payers, and the public seek evidence of improved performance. This article discusses the current impasse in the field of quality measurement and what is needed to overcome this deadlock.

[1]  P. Pronovost,et al.  Using hospital mortality rates to judge hospital performance: a bad idea that just won’t go away , 2010, BMJ : British Medical Journal.

[2]  J. Semmens,et al.  The Western Australian Audit of Surgical Mortality: advancing surgical accountability , 2005, The Medical journal of Australia.

[3]  Richard Lilford,et al.  Use and misuse of process and outcome data in managing performance of acute medical care: avoiding institutional stigma , 2004, The Lancet.

[4]  P. Pronovost,et al.  Surveillance bias and deep vein thrombosis in the national trauma data bank: the more we look, the more we find. , 2008, The Journal of trauma.

[5]  A. Cohen.  What is value in health care? , 2011, The New England journal of medicine.

[6]  Jeffrey A. Linder,et al.  Using Electronic Health Records to Measure Physician Performance for Acute Conditions in Primary Care: Empirical Evaluation of the Community-Acquired Pneumonia Clinical Quality Measure Set , 2009, Medical care.

[7]  Karla Hemming,et al.  Multiple component patient safety intervention in English hospitals: controlled evaluation of second phase , 2011, BMJ : British Medical Journal.

[8]  R. Thomson,et al.  An epistemology of patient safety research: a framework for study design and interpretation. Part 3. End points and measurement , 2008, Quality & Safety in Health Care.

[9]  C. Landrigan,et al.  Temporal trends in rates of patient harm resulting from medical care. , 2010, The New England journal of medicine.

[10]  R. Lilford.  The English Patient Safety Research Programme: A Commissioner's Tale , 2010, Journal of health services research & policy.

[11]  Simon C. Mathews,et al.  Focus on Quality: An Opportunity to Execute Health Care Reform , 2011, American journal of medical quality : the official journal of the American College of Medical Quality.

[12]  Karla Hemming,et al.  Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation , 2011, BMJ : British Medical Journal.

[13]  R. Lilford,et al.  What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature , 2007, BMC Health Services Research.

[14]  P. Pronovost,et al.  Can increased incidence of deep vein thrombosis (DVT) be used as a marker of quality of care in the absence of standardized screening? The potential effect of surveillance bias on reported DVT rates after trauma. , 2007, The Journal of trauma.

[15]  C. von Wagner,et al.  Choosing between CT colonography and colonoscopy in the diagnostic context: a qualitative study of influences on patient preferences , 2009, Health expectations : an international journal of public participation in health care and health policy.

[16]  J. Deeks,et al.  Evidence of methodological bias in hospital standardised mortality ratios: retrospective database study of English hospitals , 2009, BMJ : British Medical Journal.

[17]  Sharon-Lise T Normand,et al.  Variability in the measurement of hospital-wide mortality rates. , 2010, The New England journal of medicine.

[18]  Peter J Pronovost,et al.  The wisdom and justice of not paying for "preventable complications". , 2008, JAMA.

[19]  R. Hayward,et al.  Overestimating outcome rates: statistical estimation when reliability is suboptimal. , 2007, Health services research.

[20]  L I Iezzoni,et al.  Identification of in-hospital complications from claims data. Is it valid? , 2000, Medical care.

[21]  M. Fetters,et al.  Causes of maternal mortality in Japan. , 2000, JAMA.

[22]  Jan Terje Kvaløy,et al.  Risk-adjusted monitoring of time to event , 2010 .