Move to Refine Quality Measures Gaining Momentum

By Tinker Ready, HealthLeaders

Complaints about quality measures are as abundant as the measures themselves. But some doctors are doing something about it. They’re working to identify metrics that are “realistic and actually will have an impact on patient care.”

Call it pushback, validation, or measurement science. The revolt against the volume and usefulness of outcomes measures continues.  

The AHRQ alone lists 1,280 quality measures on its site.

Efforts are underway to both challenge and refine existing guidelines and requirements. And, wonks take note, providers and patients are on the job, too.

One example: The emergency department at Beth Israel Deaconess Medical Center in Boston’s Longwood cluster of hospitals sees more than 50,000 patients a year. Every time a patient undergoes procedural sedation in the ED, doctors there follow up with a formal quality assurance review.

Their analyses are designed to meet a Joint Commission standard that requires monitoring and evaluation of such cases, which carry the risk that comes with sedation.

Now team, including BIDMC emergency physician Jonathan Edlow, MD, has decided to examine the utility of the review. “We are trying to find out what metrics make sense and what don’t,” he told me. 

In a March paper in The Journal of Emergency Medicine, Edlow and his team reported that the review “offers little advantage over existing quality assurance markers.” They concluded that review of high risk cases “may be useful.”

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