The Q Series: What are the Types of Quality Measures?

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Q Series: Health Care Quality Answers

Q Series: A series of informative blog posts that explain the building blocks of health care quality and emerging trends in health care delivery reform.

Q: What are the types of quality measures?

A: Quality measures have their own place in health care. Let’s use wooden block sorters to illustrate. Just as they come in a variety of shapes, each shape assigned to its own slot, each quality measure fits one of four “slots”: structure, process, outcome, patient experience.

There are many types of quality measures, and they are used throughout health care, from the doctor’s office to the health insurance plan. Each quality measure provides a snapshot of specific health care services. Quality measures are necessary for determining the overall quality of care.

Structure

Measures of structure are the foundation (the “box”) of quality measurement. These measures evaluate different attributes—such as medical staff and policies—in different health care settings—such as clinics and hospitals. Regulators and health insurance companies use them to gauge a provider’s level of  quality care.

Process

If measures of structure are the foundation of quality measurement, then process measures are the blocks. Process measures use evidence-based guidelines to assess the extent and quality of services provided to patients, and incorporate evidence-based best practices into improvement efforts.

Outcome

Process measures relate to the evidence-based care administered to a patient; outcome measures evaluate the effect of that care on the patient’s health.

Outcome measures are the slots into which the process blocks fit. They look at the intended—or unintended—effect of care on the patient and assess whether care goals were met.

Process and outcome measures go hand in hand because process measures are closely associated with outcome. Improving a process can result in an improved outcome.

Patient Experience

Patient experience measures encompass process and outcome measures. They provide insight into the quality of care patients receive—for example, how quickly do patients get an appointment for urgent care? How well do doctors communicate with their patients?

Research shows that patients who have a positive experience at a provider’s office are often more engaged in their care … which leads to improved health outcomes.  Next time you go to your doctor’s office or speak with your health plan representative, ask about their quality improvement activities.

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