TY - JOUR T1 - Measuring what matters: refining our approach to quality indicators JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 305 LP - 308 DO - 10.1136/bmjqs-2022-015221 VL - 32 IS - 6 AU - Perla J Marang-van de Mheen AU - Charles Vincent Y1 - 2023/06/01 UR - http://qualitysafety.bmj.com/content/32/6/305.abstract N2 - Quality indicators are ubiquitous in healthcare and serve a variety of purposes for many different stakeholders. Few would question the value of monitoring the quality of care, but the increasing numbers of indicators and the resources consumed suggest that some reflection and refinement of approach may be required. For instance, the National Quality Forum catalogue in the USA lists 1167 indicators,1 and a recent study from the Netherlands showed that healthcare professionals from five clinical specialties collect data for 24 different stakeholders on 1380 different variables.2 Healthcare professionals in the latter study spent an average of 52 min per working day documenting for the wide range of required quality registrations, with only 36% of the indicators perceived as useful for improving the quality of care in daily practice.2 In this issue of BMJ Quality & Safety, Xu and colleagues report a study of the usefulness of nursing home indicators for assuring and improving quality of care.3 These indicators play a role in value-imbursement initiatives, and facility scores are publicly reported on Minnesota’s Nursing Home Report Card. This study is notable for focusing on the overall value of the set of indicators rather than the properties of individual indicators. The authors performed a qualitative assessment of the indicator set using literature review and expert opinion. They also examined correlations between indicators and examined the contribution of each indicator to the assessment of overall nursing home quality. They refined the indicator list, provided a clear domain structure and scoring system, making it much easier for users to understand what is being measured and how the summative assessment can be used to support decision-making. Their approach is analogous to that taken by the development of psychological tests, where the emphasis lies on carefully defining the underlying construct and developing … ER -