Accountability Measures — Using Measurement to Promote Quality Improvement

Chassin, Mark R.; Loeb, Jerod M.; Schmaltz, Stephen; Wachter, Robert M.

doi:10.1056/nejmsb1002320

Cited by 448 publications

(357 citation statements)

References 7 publications

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“…Accountability measures refer to quality measures which are publically reported, linked to financial incentives and/or used for accreditation [8]. The US Veterans Affairs (VA) health-care system has used accountability measures combined with tools in an electronic medical record to implement alcohol screening [9] and brief interventions (BI) [10].…”

mentioning

confidence: 99%

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

Bradley

Johnson²,

Williams³

2011

Addiction

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mentioning

confidence: 99%

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

Bradley

Johnson²,

Williams³

2011

Addiction

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“…For example, patients and physicians alike are most interested in preserving quality of life, survival after serious conditions, avoiding hospital readmissions, and having positive medical experiences, in general. 4,15 Despite this progress, our analysis demonstrates that CMS still needs to address some key aspects of quality with its PQRS measures. The current measures do not evenly address all NQS domains, focusing on clinical effectiveness with little emphasis on patient-centeredness, efficiency, and population health.…”

Section: Discussionmentioning

confidence: 99%

“…Predominant use of process measures is problematic because studies show that only some processes correspond with meaningful patient outcomes. 15,17 CMS must embrace its role as a leader in quality measure development and start designing outcome measures for PQRS specifically for the medical specialties that lack them. CMS also might consider collaborating specifically with additional medical specialty societies, in addition to its other measure developing collaborators, to advance measure development for medical subspecialties and non-internal medicine specialties.…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Assessment of the Quality of Physician Quality Reporting System Measures

Frankel

Bishop

2016

J GEN INTERN MED

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BACKGROUND: Starting in 2015, the Center for Medicare and Medicaid Services (CMS) requires all Medicare providers to report quality measures through Physician Quality Reporting System (PQRS) or incur a 1.5 % financial penalty. Research indicates that physicians believe this reporting does not lead to high quality care; however, little research has examined what PQRS actually measures, which is reflective of the physicians and patient disease populations being assessed. OBJECTIVES: (1) Identify the proportion of measures that apply to different medical specialties, types of quality measurement, and National Quality Strategy (NQS) priorities. (2) One hundred and ninety-eight and 254 individual measures, respectively, were analyzed by three domains: medical specialty measured, type of measure, and NQS priority category. KEY RESULTS: Between 2011 and 2015, the type of measures changed significantly, with fewer processes (85.4 % vs. 66.5 %, p < 0.001) and more outcomes (12.6 % vs. 29.1 %, p < 0.001). The measures showed no significant specialty or NQS category differences. For subcategories within each specialty in 2015, differences in measure type were statistically significant: surgery had the highest percentage of outcomes (61.1 %) compared to 21.7 % of internal medicine and 5.9 % of obstetrics/gynecology. For NQS categories, internal medicine had the highest percentage of effective clinical care measures (68.5 %), compared to 22.2 % in surgery. Surgery had the highest percentage of patient safety (31.9 %) and communication and care coordination measures (27.8 %) compared with internal medicine (5.4 % and 6.5 %). CONCLUSIONS: Our study shows that PQRS measures include many medical specialties and significantly more outcomes in recent years, particularly for surgery. PQRS still lacks sufficient measures for half of NQS priorities and sufficient outcomes to assess internal medicine and obstetrics/gynecology. CMS must continue to improve PQRS measures to better assess and encourage highquality care for all Americans.KEY WORDS: medicare; quality assessment; quality improvement; performance measurement; healthy policy.

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“…A c c e p t e d M a n u s c r i p t judgement are used to promote quality improvement. For example, Chassin et al [34] argue that recent accountability measures in US hospitals promote quality improvement. However, measurement for the purpose of accountability or judgement and measurement for the purpose of improvement of healthcare processes are two very different things [35].…”

Section: Discussionmentioning

confidence: 99%

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme

Nathwani

Sneddon²,

Malcolm

et al. 2011

International Journal of Antimicrobial Agents

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Accountability Measures — Using Measurement to Promote Quality Improvement

Cited by 448 publications

References 7 publications

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

Commentary on Nilsen et al. (2011): The importance of asking patients—the potential value of patient report of brief interventions

A Cross-Sectional Assessment of the Quality of Physician Quality Reporting System Measures

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme

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