Making measures count

Clin J Am Soc Nephrol. 2011 Jun;6(6):1507-11. doi: 10.2215/CJN.11461210. Epub 2011 May 19.

Abstract

An abundance of available laboratory information has led in part to the establishment of quantitative performance goals that use serum albumin, hemoglobin, Kt/V, and bone mineral indices to track quality of medical care and even physician reimbursement. As we look to the future, the next generation of measures should should more specifically reflect efforts to improve more fundamental outcomes, such as mortality, hospitalization, and quality of life. In this essay we address the important question of how clinicians can translate rich sources of quantitative data into a service that makes a difference in our patients' lives; a way to distinguish exemplary from ordinary care; a means to support continuous improvement in our care patterns individually and as part of larger, integrated health care systems all while avoiding prematurely advocating flawed quality measures. We also offer a pathway for how future quality measures can be developed. Our ultimate goal is to individualize quantitative assessments and by doing so encourage more meaningful, patient-oriented care that will lead to improved outcomes, greater physician job satisfaction, and wiser allocation of scarce resources.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / diagnosis
  • Anemia / therapy
  • Biomarkers / blood
  • Bone Remodeling
  • Health Status Indicators
  • Hemoglobins / metabolism
  • Humans
  • Kidney / physiopathology
  • Kidney Diseases / diagnosis
  • Kidney Diseases / therapy*
  • Kidney Function Tests / standards
  • Models, Biological
  • Nephrology / standards*
  • Nutritional Status
  • Outcome and Process Assessment, Health Care / standards*
  • Patient Satisfaction
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Quality Improvement / standards*
  • Quality Indicators, Health Care / standards*
  • Quality of Life
  • Serum Albumin / metabolism
  • Treatment Outcome

Substances

  • Biomarkers
  • Hemoglobins
  • Serum Albumin