TABLE 3-1 Purposes of Quality Measures



Quality improvement

Measures to provide information for health care institutions to reform or shape how care is provided

Clinical assessment

Measures to guide individual patient management


Measures that assess the phenomenon of interest


Measures that allow comparison of quality of care for the purposes of quality assurance or for consumer choice between health care institutions or practitioners


SOURCE: Teno et al., 1999.

TABLE 3-2 Areas of Emphasis Based on the Purpose of Quality Measure


Purpose of Measure


Clinical Assessment





Clinical staff

Science community

QI team and clinical staff

Payers, public

Focus of measurement

Status of patient


Understand care process



Very high

Very high

Very high


Evidence base to justify use of measure

Important; measure should have face validity from a clinical standpoint

Builds on existing evidence to generate new knowledge


Extremely important in that proposed domain ought to be under control of the institution

Importance of psychometric properties

Important to individual provider

Extremely important to the research effort

Important within specific setting

Valid and responsive across multiple settings


SOURCE: Adapted from Solberg et al. (1997) and Teno et al. (1999).

tions of the use of measurement tools, more stringent psychometric properties than are now employed must be put into measures that will be used for public accountability. In addition, there must be either normative or empirical research substantiating a claim that the construct being measured for public accountability is under the control of the health care institution.

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