Segment 2: Striking the Balance With Quality Metrics

Jason C. Goldwater, MA, MPA, senior director, National Quality Forum (NQF), explained that quality metrics exist for 3 purposes: to ensure the best science and practices are being utilized, to set the bar for what good quality looks like, and to keep up with the evolving nature of healthcare.
The NQF, Mr Goldwater said, views quality measures as important tools that ensure patients are being treated with only the best practices and science available to them. But even more so, quality measures help define what the best care may look like, setting the standard for what should always be considered “good” quality. The measures, in turn, allow them to evaluate clinical settings that yield the best patient outcomes and where there may be room for improvement.
Quality metrics have developed over time, allowing physicians and healthcare stakeholders to understand standards and improvement in quality. According to Mr Goldwater, quality metrics barely existed in the 1990’s, let alone understanding how to put these measures to effective use.
“We were all scratching our heads about how to effectively measure clinical outcome and be able to understand whether we were able to ascertain a good performance metric from that,” Mr Goldwater said. “And now, you flash forward to 2016, there are 600 plus NQF-endorsed measures and probably approximately 2500 quality measures overall because we’ve been able to develop measures and figure out ways of evaluating clinical outcomes, processes, and structures. It’s allowed us to keep in line with the advances in medicine.”
The National Quality Forum upholds a rigorous program that evaluates measures and places them before subject-matter expects to help understand whether or not the quality measures are appropriate for clinical environments. The organization asserts that quality measures must not only be reliable and feasible, but that they must also be usable, as not to interrupt the workflow of nurses and physicians.
“You don’t want to get so wrapped up in trying to report out a quality measure that you’re taking time away from the patient. That’s never the intent,” Mr Goldwater said. “The intent is to continue to spend time with the patient while also understanding what the best practices are for quality, and being able to have data populate that measure to indicate the threshold at which we know quality is being reached.”
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