Health Care Quality Measurement

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What Influences Quality Improvement Processes in Health Care?

Periods of rapid change offer both opportunities and challenges for health care quality improvement. Understanding the building blocks that need to be in place to support improvement processes may help those seeking to embed improvement capabilities and capacity into their organisations, both as we emerge from the COVID-19 pandemic and beyond.

Gemma-Claire Ali, Emily Ryen Gloinson, et al.

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A New Way to Capture the Patient Experience

Researchers have developed a more effective and reliable way for patients to provide narrative feedback about the care they receive. When the right questions are asked, patients' answers can help health care providers better understand the patient experience and learn how they could improve.

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How a New Tool Could Help Mental Health Providers Deliver More Effective Care

The mental health workforce needs the proper tools to meet the needs of the communities it serves. A key element of this is high-quality training in how to deliver evidence-based treatments. RAND developed a new tool designed to assess how well a specific training aligns with the most critical features of effective training.

Kimberly A. Hepner @KimberlyHepner, Terri Tanielian, et al.

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How Private Health Care Providers Could Better Serve Veterans

Almost a third of U.S. veterans live 40 miles or more from the nearest VA medical center, so the VA is trying to make it easier for them to use private providers closer to home. But it will take significant efforts to better prepare civilian doctors to deliver high-quality care to veterans.

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Personalized Hospital Ratings: Transparency for the Internet Age

Each annual release of hospital ratings captivates journalists, hospital leaders, and health care consumers in the United States. These ratings aggregate many measures into a single score for each hospital. But why should the opinions of report creators hold sway, if the intent is to inform patient choice? Why not ask patients instead?

Juliet Rumball-Smith, Jill Gurvey, et al.

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Getting Doctors to Make Better Decisions Will Take More than Money and Nudges

While monetary incentives and behavioral nudges both have their strengths, neither is enough to reliably change clinician behavior and improve quality of care. Organizational culture provides another important lens to understand why clinicians are practicing in a certain way and to put forth more comprehensive, long-term solutions.

Yusuke Tsugawa, John N. Mafi

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Beyond Medication Reconciliation: The Correct Medication List

Primary care clinicians are expected to reconcile a patient's medications at every visit. In practice, this has failed to have a demonstrable effect on patient outcomes. What is needed is not merely a reconciled list, but the correct list.

Adam J. Rose, Shira H. Fischer @ShiraFischer, et al.

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Improving MACRA's Chances of Success

Starting in 2019, the Medicare Access and CHIP Reauthorization Act will integrate and potentially simplify performance measurement by combining many measures and programs. Research provides insight into how to avoid pitfalls in MACRA's rollout.

Adam J. Rose, Peter S. Hussey, et al.

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Toward a Learning Behavioral Health Care System

New technologies for capturing and sharing data have begun to transform the way providers practice medicine in the United States. Expanding these technologies to behavioral health care could enhance the delivery of services and improve outcomes for millions of Americans.

Bradley D. Stein @BradleyDStein

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Scoring the Surgeon Scorecard

There is no tradeoff between recognizing the serious methodological problems in the ProPublica Surgeon Scorecard, improving the Scorecard, and encouraging providers to release their own data. All three can and should be done simultaneously.

Mark W. Friedberg

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Can Patient-Centered Outcomes Research Improve Health Care?

A review in 2017 of the adequacy and use of Patient-Centered Outcomes Research Trust Funds will be used to determine whether funding levels should be continued or adjusted after its authorization runs out in 2019. Researchers ought to take stock of the work in patient-centered outcomes research.

Thomas W. Concannon @tconcannon

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More Long-Term Health Conditions, Poorer Health Care Experiences

Patients with multiple long-term health conditions are more likely to report poorer experiences in primary care than those with fewer health problems. A patient-centered model that takes into account the severity of disease — and the impact of combinations of diseases, on patient quality of life and health care experiences — could make a difference.

Catherine L. Saunders, Charlotte Paddison

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The Great Patient Experience Survey Myth

Patient experience with care is an essential element in any assessment of health care quality. Surveys give patients a voice and provide fair and relevant indicators that complement other metrics of health care quality to inform patients' choices and providers' decisions about how to improve care.

Rebecca Anhang Price, Marc N. Elliott

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Putting Patients First Can Result in Better Care Overall

Better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization.

Rebecca Anhang Price, Marc N. Elliott, et al.

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The ACA's Opportunity to Improve Care for Substance Use Disorders

The Affordable Care Act (ACA) will significantly increase coverage for the publicly funded treatment of substance use disorders. But in order to maximize the benefit to patients, families, and society, it's critical to invest in the development, validation, and use of performance measures.

Katherine E. Watkins

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Do You Get What You Pay For? Maybe Not in Health Care

While the current state of the evidence does not provide clear guidance to policymakers seeking to address the twin pillars of health care quality and cost, it is apparent that researchers must produce more detailed data on how to reduce health care spending while improving quality, writes Peter Hussey.

Peter S. Hussey

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Are You a 'Wise' Health Care Consumer?

To be wise purchasers of health care services, consumers need access to accurate and understandable information about health plans and providers. They wrongly assume that more expensive providers are better than less expensive ones, despite inconsistent evidence that there is any link between health care cost and quality.

Ramya Chari, Arthur L. Kellermann

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Creating More Savvy Consumers Through Public Reporting

Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are designed to capture patients' experiences in a systematic way that facilitates reporting the results publicly to help other consumers make more savvy care decisions. Consumer choices may influence providers to improve the care they offer so that they can effectively compete in the market.

Mary E. Vaiana

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Unraveling the IT Productivity Paradox—Lessons for Health Care

Although health care organizations have favorable characteristics that can maximize IT's benefits, the reengineering of health care delivery is only beginning, write Spencer Jones, Paul Heaton, Robert Rudin, and Eric Schneider.

Spencer S. Jones, Paul Heaton, et al.

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Using Patient Surveys to Rate Hospitals

Hospitals that perform better on the survey tend to do better on clinical measures, have fewer readmissions within 30 days and have lower risk-adjusted mortality, write Marc Elliott and Alan Zaslavsky.

Marc N. Elliott, Alan M. Zaslavsky