Features by Patrice L. Spath; and Ron J. Anderson, MD, Ruben Amarasingham, MD, and S. Sue Pickens
We all know that measuring performance in healthcare is not an easy task. It’s costly, inefficient, and in flux. And yet it has to be done—not only because the data are mandated by various agencies and linked to incentives, but also because organizations are more likely to improve by measuring and comparing their data with others. In this edition of Frontiers , seven experts weigh in on this issue, providing insights and guidance for senior executives.
In “Taming the Measurement Monster,” Patrice Spath, a national consultant on healthcare quality and safety, suggests that senior leaders can “create a meaningful and efficient performance measurement system that complements the quality mission of the organization and meets the expectations of purchasers, accrediting bodies, and consumers.” She provides steps for maximizing an organization’s performance measurement system and tools to integrate externally defined measures with an organization’s own measurement priorities. Spath also emphasizes the importance of executive leadership in the process.
Ron J. Anderson, MD, Ruben Amarasingham, MD, and S. Sue Pickens of Parkland Health and Hospital Systems in Dallas illustrate how one healthcare system approached the “measurement monster.” Parkland’s approach focuses on three components: the role of senior leaders in institutionalizing quality into the fabric of the organization; the process of data selection, collection, and analysis; and the development of a robust outcomes research infrastructure.
They conclude with a discussion of several concrete steps to manage and improve clinical processes.
For Thomas C. Royer, MD , president and CEO of CHRISTUS Health in Texas , measurement is a necessity, not a luxury. However, to be successful these measures must accompany an organizational shift to a culture of transparency and accountability. All members of the healthcare delivery process must feel and be responsible for the care delivered. Robert C. Lloyd, PhD, executive director of performance improvement at the Institute for Healthcare Improvement in Cambridge, Massachusetts, emphasizes the need to measure processes as well as outcomes. He also states that different study designs work for different outcomes. Lloyd suggests using statistical process control methods to demonstrate that the changes made do in fact produce sustainable results over time. Finally, Donna J. Slovensky, PhD, a professor at the University of Alabama, emphasizes that the ability to benchmark or compare one’s performance against that of competitors is essential. She cautions that although statistical rigor is important in outcomes measurement, we must not allow academic discussions about indicator validity and reliability to obscure the need to focus on the utility of the information for decision making.
Until national measures are standardized, measuring performance will remain challenging. The authors present a context for the measurement monster and provide solutions, strategies, and case examples for moving forward.
A Personal Note: This is my final issue as editor of Frontiers of Health Services Management. Janet Davis and I have enjoyed serving in this role for the past three years, but must now focus on other responsibilities at Health Administration Press. We are proud to have been affiliated with Frontiers and look forward to its continuing success in the future. We also leave the journal in the vary capable hands of a new editor, Margaret F. Schulte, FACHE, who will take the helm starting with the next issue.
Audrey Kaufman, Editor