A New Era in Quality Measurement: The Development and Application of Quality Measures

Abstract

Quality measures are used for a variety of purposes in health care, including clinical care improvement, regulation, accreditation, public reporting, surveillance, and maintenance of certifi cation. Most quality measures are 1 of 3 types: structure, process, or outcome. Health care quality measures should address the domains of quality across the continuum of care and refl ect patient and family experience. Measure development for pediatric health care has a number of important challenges, including gaps in the evidence base; the fact that measures for most conditions must be agespecifi c; the long, resource-intensive development process; and the national focus on measure development for adult conditions. Numerous national organizations focus on the development and application of quality measures, including the Pediatric Quality Measures Program, which is focused solely on the development and implementation of pediatric-specifi c measures. Once a quality measure is developed for use in national measurement programs, the organization that develops and/or "stewards" the measure may submit the measure or set of measures for endorsement, which is recognition of the scientifi c soundness, usability, and relevance of the measure. Quality measures must then be disseminated and applied to improve care. Although pediatric health care providers and child health care institutions alike must continually balance time and resources needed to address multiple reporting requirements, quality measurement is an important tool for advancing high-quality and safe health care for children. This policy statement provides an overview of quality measurement and describes the opportunities for pediatric health care providers to apply quality measures to improve clinical quality and performance in the delivery of pediatric health care services.

Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process

“…There is an increasing focus internationally on improving the quality of maternity care and the development and application of measures to drive quality improvement . Two key policy drivers relevant to improving the quality of maternity care have recently been introduced in England.…”

“…Other authors have noted the challenges of developing metrics to drive quality improvement, and noted that gaps in the evidence base are a problem . Over the past decade, researchers have developed methodology for identifying outcomes that key stakeholders deem important in defining successful treatment of specific conditions with much of this work taking place within the COMET initiative.…”

“…There is an increasing focus internationally on improving the quality of maternity care and the development and application of measures to drive quality improvement. [1][2][3] Two key policy drivers relevant to improving the quality of maternity care have recently been introduced in England. The first of these was the announcement by the government in November 2015 of a national ambition to reduce maternal mortality, stillbirth, neonatal mortality and serious neonatal injury by 20% by 2020, and 50% by 2030.…”

“…Other authors have noted the challenges of developing metrics to drive quality improvement, and noted that gaps in the evidence base are a problem. 1 Over the past decade, researchers have developed methodology for identifying outcomes that key stakeholders deem important in defining successful treatment of specific conditions [6][7][8][9][10][11] with much of this work taking place within the COMET initiative. Such methodology generally consists of four stages: a systematic review to identify reported outcomes, qualitative work to identify outcomes considered important by patients, a Delphi process to prioritise outcomes, and finally a face-toface consensus meeting.…”

The Landscape of Quality Measures and Quality Improvement for the Care of Hospitalized Children in the United States: Efforts Over the Last Decade

“…4 Hospitals report to many programs, often the same indicator is included in .1 set and is used for a variety of purposes. 4,7 Clearly, an explosion of development of QMs for the assessment of care provided to hospitalized children has taken place over the last few years. However, this dramatic expansion has not occurred in a systematic and coordinated fashion.…”