Measuring quality of care: considering measurement frameworks and needs assessment to guide quality indicator development.

OBJECTIVE

In this article, we describe one approach for evaluating the value of developing quality indicators (QIs).

STUDY DESIGN AND SETTING

We focus on describing how to develop a conceptual measurement framework and how to evaluate the need to develop QIs. A recent process to develop QIs for injury care is used for illustration.

RESULTS

Key steps to perform before developing QIs include creating a conceptual measurement framework, determining stakeholder perspectives, and performing a QI needs assessment. QI development is likely to be most beneficial for medical problems for which quality measures have not been previously developed or are inadequate and that have a large burden of illness to justify quality measurement and improvement efforts, are characterized by variable or substandard care such that opportunities for improvement exist, and have evidence that improving quality of care will improve patient health.

CONCLUSION

By developing a conceptual measurement framework and performing a QI needs assessment, developers and users of QIs can target their efforts.