PERFORMANCE BASED FACTORS

Performance Based Factors and Measures for Quality Assessment



Performance Based Factors and Measures for Quality Assessment

An effective measurement system integrates initiatives, aligns organizational units and resources, and improves performance. Paradoxically, most people select measures before they decide how to use them. While it makes sense to discuss selection and use of measures in that order, the effective order in practice is the reverse.

Organizations need performance measures in three areas:

To lead the entire organization in a particular direction.

To manage the resources needed to travel in this direction.

To operate the processes that make the organization work.

Most organizations typically don't use leadership measures. However, many health care organizations have struggled to move beyond their heavy emphasis on financial measures to include leadership measures. With continuous quality improvement entrenched at the process level, these same organizations struggle to better manage their resources because they don't consider the effects of structures. Without an integration of clinical and financial measures, the same organizations will find it nearly impossible to effectively operate the processes they are so keen on improving.

In order to categorize and evaluate quality measures for behavioral healthcare systematically, it is key to begin with a framework. Referring to Donabedian's classic and oft cited work (Donabedian, 1980), quality measures can include structure, process and outcome measures as well as access and patients' experience (Agency for Healthcare Research and Quality, 2004). Each type of measure needs to be considered in terms of a specific use, however, because the assessments of cost, accuracy, aggregation and data source all depend on the purpose of a performance measure.

Structure.

A structure measure is a feature of a healthcare organization, provider practice, or health system relevant to its capacity to provide health care. For example, the existence of an electronic medical records system or the ratio of mental ...