Magazine article Clinical Psychiatry News

IOM Calls for Standard Performance Measures

Magazine article Clinical Psychiatry News

IOM Calls for Standard Performance Measures

Article excerpt

While various organizations have made substantial progress developing health care performance measures, it's time for Congress to establish an entity that can standardize these measures across the health care system, according to a report from the Institute of Medicine.

Such a board should be part of the Department of Health and Human Services, according to the report.

In particular, any participating provider should be required to submit performance data to the board, so that Medicare could use the information for quality improvement activities or as a basis for payment incentives and public reporting, the IOM committee wrote. The committee's efforts were mandated by Congress and sponsored by the HHS.

In a statement, Dr. C. Anderson Hedberg, president of the American College of Physicians, praised the IOM's intention to establish a centralized organizing structure.

"This may be one way to set clear quality goals, coordinate performance measurement efforts, support fair comparisons of cost and quality, and ensure stable funding for organizations involved in performance measurement," Dr. Hedberg said.

A standard nationwide set of measures "would avoid the morass of everyone developing their own, including the government," Dr. Larry Fields, president of the American Academy of Family Physicians, said in an interview.

But it may not necessarily take a national board to get people to adopt a consensus on measures, he added. The key is to have a set of measures that are accepted as reasonable by these programs. "Other measures can be added as necessary."

Performance measures are benchmarks by which health care providers and organizations can determine their success in delivering care. Examples include regular blood and urine tests for diabetic patients, a facility's 30-day survival rate among cardiac bypass patients, or perceptions of care collected from patient surveys.

The problem is all of these independent initiatives have led to duplication in some areas and neglect in others that are important to national health goals, the committee noted. Individual stakeholders understandably focus on certain features of care that they consider to be the highest priority for improvement. "But they frequently overlook areas of national interest that are difficult to quantify, such as whether care is equitable, efficient, and well coordinated."

As an initial step toward achieving a universally accepted set of measures, the report recommended the adoption of an evidence-based "starter set" of existing measures that would cover care delivered in ambulatory, acute care, and long-term care settings and in dialysis centers. …

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