Defining and classifying clinical indicators for quality improvement
International Journal for Quality in Health CarePublished 1 December 2003Open access
Jan Mainz
Citations1,089
SJR quartileQ2
SJR score0.85
SNIP1.11
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Monitoring health care quality is impossible without the use of clinical indicators, and they create the basis for quality improvement and prioritization in the health care system.
Abstract
Monitoring health care quality is impossible without the use of clinical indicators. They create the basis for quality improvement and prioritization in the health care system. To ensure that reliable and valid clinical indicators are used, they must be designed, defined, and implemented with scientific rigour.
Keywords
Health ProfessionsEconomics, Econometrics and Finance
Evidence-Based Medicine: How to Practice and Teach EBM
5,970 Citations2000David L. Sackett
This chapter discusses how to ask clinical questions you can answer and critically assess the evidence for evidence-based medicine, as well as 7 Rapid Reference Cards used in clinical practice.
Milbank QuarterlyEvaluating the Quality of Medical Care
5,939 Citations2005Avedis Donabedian
This paper deals almost exclusively with the evaluation of the medical care process at the level of physician-patient interaction and excludes processes primarily related to the effective delivery of medical care at the community level.
JAMAThe quality of care. How can it be assessed?
5,938 Citations1988Avedis Donabedian
Assessing quality depends on whether one assesses only the performance of practitioners or also the contributions of patients and of the health care system, how broadly health and responsibility for health are defined, and on whether the maximally effective or optimally effective care is sought.
The Milbank Memorial Fund QuarterlyEvaluating the Quality of Medical Care
4,319 Citations1966Avedis Donabedian
Annals of Internal MedicineClinical Epidemiology: A Basic Science for Clinical Medicine.
3,508 Citations1991
Clinical Epidemiology is a book dedicated to H.L. Mencken, Kurt Vonnegut, Jr., Douglas Adams, and the Emperor's New Clothes and Physicians and others who wish to recognize key clinical epidemiologic features of the diagnosis and management of patients will benefit from reading.
JAMAThe Urgent Need to Improve Health Care Quality<SUBTITLE>Institute of Medicine National Roundtable on Health Care Quality</SUBTITLE>
1,249 Citations1998Mark R. Chassin
Milbank QuarterlyHow Good Is the Quality of Health Care in the United States?
920 Citations1998Mark A. Schuster, Elizabeth A. McGlynn +1 more
Efforts to measure quality and report routinely on the results to the public at large would allow more definitive assessments of the status of the nation's health care and would enable us to single out the areas in need of improvement.
Journal for Healthcare QualityMedicare: A Strategy for Quality Assurance
636 Citations1991Kathleen N Lohr
The committee intended that such a program respond to several major issues, including: the burdens of harm of poor quality of care, difficulties and incentives presented by the organization and financing of healthcare, the state of scientific knowledge, and the need to foster successful internal, organization-based QA programs.
International Journal for Quality in Health CareProcess versus outcome indicators in the assessment of quality of health care
610 Citations2001Jonathan Mant
This paper reviews the relative strengths and weaknesses of outcome and process measures as performance indicators in health care and suggests alternative strategies such as process measurement and risk management techniques may be more effective at protecting the public from poor quality care.
ScienceThe Quality of Medical Care
580 Citations1978Avedis Donabedian
The article reviews the developments that led to the involvement of the federal government in this activity through its sponsorship of professional standards review organizations (PSRO) and the major features of the PSRO's are described and their possible effects discussed.
JAMAThe Risks of Risk Adjustment
408 Citations1997Lisa I. lezzoni
This article examines severity measures used in states and regions to produce comparisons of risk-adjusted hospital death rates and concludes that Severity does not explain differences in death rates across hospitals.
International Journal for Quality in Health CareThe advantages and disadvantages of process-based measures of health care quality
375 Citations2001Haya R. Rubin
The advantages and disadvantages of process measures of quality are discussed, some practical strategies and issues in implementing them are outlined, and the importance of validated process of care measures is highlighted.
International Journal for Quality in Health CareDeveloping evidence-based clinical indicators: a state of the art methods primer
291 Citations2003Jan Mainz
Using clinical indicators for quality assessment represents an important approach to documenting the quality of care and underlines the fact that clinical indicators must be developed and tested with scientific rigor in a transparent process.
International Journal for Quality in Health CareMethodology Matters. From a process of care to a measure: the development and testing of a quality indicator
252 Citations2001Haya R. Rubin
The future should bring the development and implementation of quality indicators that are rigorously developed and that will provide insights into opportunities to improve the quality of care.
The Annals of Thoracic SurgeryThe volume-outcome relationship: from Luft to Leapfrog
227 Citations2003David M. Shahian, Sharon‐Lise T. Normand
Whenever possible, risk-adjusted outcome data should supplement or supplant volume standards, and continuous quality improvement programs should seek to emulate the processes of high-volume, high-quality providers.
QRB - Quality Review BulletinCharacteristics of Clinical Indicators
92 Citations1989
This section of the Primer defines clinical indicators and discusses their use in monitoring and evaluating factors in patient care, and examples of the two types of indicators, sentinel event and rate-based, are given.
Medical CareIndividual and Institutional Variables Which May Serve as Indicators of Quality of Medical Care
90 Citations1979R. Heather Palmer, Margaret C. Reilly
A critical review of empiric studies that investigated associations between characteristics of physicians and medical care institutions and some measure of the quality of medical care given by them and derives a list of 14 which appear to be the best choice of indicators on which further research might focus.
PubMedAssessing the quality of healthcare provided to children.
65 Citations1998Rita Mangione‐Smith, Elizabeth A. McGlynn
A conceptual framework for evaluating quality of care for children and adolescents is presented, the key issues related to developing measures to assess pediatric quality of Care are summarized, some existing measures are examined, and evidence about their current level of performance is presented.
Archives of Pediatrics and Adolescent MedicineDevelopment of a Quality of Care Measurement System for Children and Adolescents
62 Citations1997Mark A. Schuster
A pediatric quality of care measurement system designed to cover multiple clinical topics that could be applied to enrollees in managed care organizations and to compare the development of this system with the concurrent development of a similar system for adult women is described.
International Journal for Quality in Health CareUsing health outcomes data to compare plans, networks and providers
49 Citations1998H Palmer
Comparing process data may reveal more about performance of plans, networks and providers than comparing outcomes data because comparisons of process data are easier to interpret and more sensitive to small differences than comparisons of outcomes data.
Annals of Internal Medicine100 Apples Divided by 15 Red Herrings: A Cautionary Tale from the Mid-19th Century on Comparing Hospital Mortality Rates
45 Citations1996Lisa I. Iezzoni
Even hospital mortality rates, a seemingly straightforward staple of many provider report cards, can be modulated by the manner in which they are calculated, and this historical example underscores the need to open black boxes and look inside.
International Journal for Quality in Health CareThe outcomes utility index: will outcomes data tell us what we want to know?
36 Citations1998Elizabeth A. McGlynn
The approach proposed here is intended to provoke discussion and more rigorous development of tools that will help to identify the measures that are likely to produce the most useful information for making comparisons among accountable entities in the health system.
PubMedNosocomial infection indicators in Australian hospitals: assessment according to hospital characteristics.
5 Citations1997Mansour Ansari, Brian T. Collopy
It is suggested that hospital type and bed size are initial indices for 'flagging' peer group variation and prompting a more detailed internal review.
RAND Corporation eBooksDevelopment of a quality of care measurement system for children and adolescents:: methodological considerations and comparisons with a system for adult women
2 Citations1999Schuster, Mark A., Asch, Steven M. +4 more