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Developing a Quality Measurement Strategy in an Academic Primary Care Setting

An Environmental Scan

Dalton, Alexandra F.; Lyon, Corey; Parnes, Bennett; Fernald, Douglas; Lewis, Carmen L.

doi: 10.1097/JHQ.0000000000000155
Original Article

Purpose: The purpose of this project was to: (1) develop a strategy for primary care quality measurement using an environmental scan and interviews to identify best practices and candidate measures; (2) present recommendations to facilitate successful measurement.

Methods: Following stakeholder interviews and review of existing measures, we created a three-tiered recommendation system for selecting and implementing measures. We also developed a framework for reviewing and prioritizing measures and prepared a detailed project report.

Results: Interviews provided a broader perspective on measuring quality, including implementing measures, measuring value, and identifying measurement gaps. Our recommendations fall into three tiers: Tier 1 measures can be implemented quickly and include clinical processes and outcomes for preventive care and disease states. Tier 2 measures require modifications to electronic health record, workflows, and/or staff preparation. Tier 3 (Strategic Vision) addresses topics that should be incorporated in the future to ensure high-quality primary care (adherence, patient activation, patient experience, teamness, staff satisfaction, and value), and infrastructure development to support ongoing quality measurement.

Conclusions: Implementing a quality measurement strategy is challenging and labor-intensive but is necessary to improve healthcare quality. Our work demonstrates the effort and investment required to progress quality measurement and offers recommendations for successfully undertaking this type of endeavor.

For more information on this article, contact Alexandra F. Dalton at

The authors declare no conflicts of interest.

© 2018 National Association for Healthcare Quality
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