Measuring health care quality isn't nearly as straightforward as many think it is. I offer perspective on some of the gaps in current approaches to measuring healthcare quality.
at Stanford University. In the study, Milstein and his colleagues used commercial health insurance claims to identify physician-practice sites across the country that delivered high-quality care with a lower overall cost. They then conducted extensive site visits to determine what these practices were doing right.
Another researcher who’s done important research into how to measure care is the child psychiatrist Gordon Harper of Harvard Medical School. Harper hasthat, in child and adolescent mental health policy, “much emphasis has been placed on demonstrating processes.” He suggests that’s because “process, indeed, is much easier to measure than outcomes.”
Someone who’s not ready to write off the value of measurement is Dr. Lori Tishler, at Commonwealth Care Alliance, a not-for-profit, community-based healthcare organization. “Some metrics are really good,” Tishler told me recently. She points to checklists that ensure patients receive mammograms and other regular screenings. “Screening tests can save somebody’s life,” she says. “They’re reasonable ways to measure quality when we look at data points.
“Hospitals should be clean and employees should be courteous. But that’s just the beginning,” says Tishler, who says patient surveys are valuable because they help her ensure that her staff is “doing things because they’re right for the patient. And often what’s right for the patient is right for the bottom line.”
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