RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd
SP 182
OP 186
DO 10.1136/qshc.2006.021170
VO 17
IS 3
A1 S Mattke
YR 2008
UL http://qualitysafety.bmj.com/content/17/3/182.abstract
AB 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.