JAMA Article: Facilitating QI Pushing the Pendulum Back Toward Process Measures

Joseph Kim, MD, MPH, MBA
Oct 09, 2015 8:57 AM

This article in JAMA titled, "Facilitating Quality Improvement - Pushing the Pendulum Back Toward Process Measures" caught my attention the other day. The author starts by reflecting on the ongoing debate: should we focus more on VTE rates (clinical outcome) vs. VTE prophylaxis adherence (process measure)? They are both important, but some organizations seem to be placing greater focus (and incentives) on outcome measures over process measures.  

The author specifically notes:

Process measures are particularly relevant for cancer care for which adherence to guidelines is far more useful for QI than measuring the distant outcome of 5-year survival. Adherence to process measures can also be a sign to the public and oversight agencies that hospitals and clinicians are committed to excellent care. 

Yet adherence to guidelines is not easily measured since there are so many unique patient factors that may impact how an oncologist interprets and follows guidelines. How are you currently assessing process measures (such as adherence to guidelines) and developing QI initiatives focused on making improvements?