TY - JOUR T1 - When should measures be updated? Development of a conceptual framework for maintenance of quality-of-care measures JF - Quality and Safety in Health Care JO - Qual Saf Health Care SP - 182 LP - 186 DO - 10.1136/qshc.2006.021170 VL - 17 IS - 3 AU - S Mattke Y1 - 2008/06/01 UR - http://qualitysafety.bmj.com/content/17/3/182.abstract N2 - Objective: To document current practices on long-term maintenance of quality measures and to develop a consensus framework to guide the design of maintenance systems.Study Design: Survey of 10 organisations developing measures and selected researchers in the USA about current policies and procedures and desirable properties for a comprehensive system for measures maintenance. Panel discussions with all respondents to arrive at consensus recommendations for a framework for maintenance of measures.Participants: Five measures developers, two provider and three purchaser organisations. Six were private sector organisations, two were governmental agencies, and two were accreditation institutions.Principal findings: All organisations had procedures for measures maintenance, but the degree of formalisation of the procedures varied. Three key functions for a measures maintenance system emerged: ad hoc review to deal with unexpected problems; annual maintenance to incorporate changes in coding conventions; and regular re-evaluation to thoroughly review measures at predefined intervals. Importance, scientific soundness, feasibility and usability were universally used as evaluation criteria. The panel discussions yielded a consensus set of recommendations for relationships between maintenance functions, evaluation criteria and measures disposition.Conclusions: A sufficient degree of implicit consensus was found among leading measures developers to arrive at a consensus framework for policies and procedures for measures maintenance. Although organisations may choose to implement the framework in a way that is most consistent with their mission and structure, it provides guidance regarding which components should be included. ER -