A Research Agenda to Advance Quality Measurement and Improvement

Published in: Medical Care, v. 41, no. 1, suppl., Jan. 2003, p. I-80-I-86

Posted on RAND.org on January 01, 2003

by Sheila Leatherman, Judith Hibbard, Elizabeth A. McGlynn

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BACKGROUND: In developing a conceptual framework for the design of a national quality measurement and reporting system (NQMRS), the Strategic Framework Board (SFB) recommends that such a system be built on a strong evidence base. OBJECTIVES: To identify critical gaps in the evidence needed for a fully functional NQMRS and to recommend a starting point for the development of a research agenda. RESEARCH DESIGN: Selective review of literature in quality of care measurement and reporting and identification of strategic issues that must be addressed. FINDINGS: There is some limited evidence that measurement and reporting can improve quality. Substantial advances have been made in the science of measurement and reporting but important gaps remain, specifically in (1) measurement methods and tools, (2) uses of quality performance data, (3) organizational and cultural factors, (4) information and informatics, and (5) impact evaluation/research. CONCLUSIONS: To achieve a sustainable research agenda, three strategic issues will have to be addressed: (1) the policy rationale for the research agenda, (2) adequate levels of public-sector funding, and (3) sustainability in a rapidly changing environment.

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