Don’t Measure to Report, Measure to Learn
How do you envision the best way to improve health outcomes? For me, it’s by measuring, monitoring and improving the right measures. Quality measures are the backbone of better health outcomes.
Data points that convey the value of health care, insights discovered in trends, why clinicians show up to work every day—these are all driven by quality measures. But despite their critical role in creating health outcomes, it’s easy to get caught up in the reporting details and forget to learn from the measures themselves.
The “Task” Problem of Quality Measurement
Health care leaders use quality measures to determine baseline performance, confirm problems and understand operations, typically as part of value-based contracts. Newer models of value-based care are starting to lean more heavily on electronic methods of measuring quality—sometimes in digital environments that lack the robust standardization measures rely on. Further
adding to the time burden and complexity of reporting, health care leaders also participate in multiple programs that have different measures and specifications.
It’s easy to see how health care teams can end up focusing on meeting minimum requirements, reporting measures once or only a few times a year. Not using quality data regularly can limit their ability to know what’s going well (and what isn’t), making it hard to grasp the purpose and power of measurement. Quality measurement turns into a check-the-box activity—just
another task—when in fact the power of quality measurement is in learning.
Extending Measurement Beyond Reporting
Placing learning at the center of quality measurement requires a shift in perception, a reorientation to its purpose and how we approach it. Quality measurement should be more than just reviewing measure specifications, understanding documentation workflows and running reports.
Effective quality measurement is a conversation. We must listen close enough to hear how and why health outcomes are created.
To learn and understand the work better, there are important questions teams should ask:
· What is this measure telling us that we didn’t already know?
· What are the implications, for us and for our community?
· How are we ensuring that the right interventions are being done for every patient, every time?
· How might we fail, and how are we actively preventing failure?
· Why is measurement difficult, and how will we tackle obstacles to create a culture of continual improvement?
To be clear, I’m not just talking about closing a gap right now; I’m talking about closing a gap forever. There must be a noticeable difference in our mindset, in our approach and, ultimately, in our results. Health care leaders know how to solve problems and can extol the importance of looking for root causes. Teams can use that attitude to transition seamlessly from viewing quality measurement as a reporting task to embracing it as a learning endeavor.
Quality measurement can be a top-down phenomenon. Payers set minimum requirements for reporting, but we are free to choose how—and how well—measures are used in our own organizations. Most reporting is periodic measurement, but if we capitalize on the opportunity to use measurement to learn about our processes, we can educate teams on the factors that create positive health outcomes and empower them to take quality to the next level. Consider your own approach to quality measurement. How can you get the results you want?