Quality measures create an objective assessment of how well healthcare providers adhere to evidence-based standards of care to achieve desired outcomes. Measures can be used to evaluate the structure, process, and outcomes of care. Structural quality measures include such things as staff certifications, accreditation, and whether a practice or facility has the information technology in place to easily and accurately monitor and report care for patients. Structural measures are often thought of as minimum standards—necessary qualifications, but not sufficient to ensure the quality of care.
Measures that look at process of care provide more direct evidence of quality care, since they document whether key processes and procedures took place during the patient’s care. Immunization rates and administration of prophylactic antibiotics to prevent surgical wound infections are both examples of process measures. Most measures of patient experience of care are also process measures, such as whether a doctor explains tests and treatments in a way the patient can understand.
Because process measures only examine components of care, the ultimate measures of quality are outcomes measures that examine whether the outcomes for a population of patients are better, the same, or worse than expected for other comparable patients. Commonly tracked outcomes measures include surgical site infection rates, mortality rates, and rates of hospital readmission within a defined period of time. Outcomes measures better reflect the totality of care provided, not just component processes and procedures.