An Evidence-Based National Quality Measurement and Reporting System

Published in: Medical Care, v. 41, no. 1, suppl., Jan. 2003, p. I-8-I-15

Posted on RAND.org on December 31, 2002

by Elizabeth A. McGlynn

Read More

Access further information on this document at www.lww-medicalcare.com

This article was published outside of RAND. The full text of the article can be found at the link above.

BACKGROUND: Evidence-based medicine and evidence-based guidelines are widely supported among physicians and other health professionals, although practice may still fall far short of the ideas contained in the concept. Insufficient attention has been given to using the concepts of evidence-based practice in the selection of measures, diffusion of innovations, and adoption of quality improvement (QI) techniques. OBJECTIVES: To describe in greater detail how evidence serves as a foundation for a national quality measurement and reporting system (NQMRS) and to consider the different types of evidence that will be used. The role of the NQMRS in adding to the evidence base is explored. RESEARCH DESIGN: A descriptive, conceptual discussion. RESULTS: Many different types of evidence are available for use in the NQMRS. The NQMRS could add substantial new evidence on how well different approaches to quality measurement, reporting, and improvement work and also expand the evidence base on the effectiveness of clinical interventions for which efficacy has been established. CONCLUSIONS: An evidence-based NQMRS will require substantial leadership from government and private entities. The gains from a greater focus on evidence are expected to be found in accelerating QI. Reliance on evidence-based approaches should not be used to stifle innovation.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.