these goals that encompass the care of patients across the lifespan (e.g., staying healthy, getting better, living with chronic illness, and coping with end of life) (FACCT, 1997).

Principle 3: Longitudinal Measurement

Standardized performance measures should characterize health and health care of a patient both within and across settings and over time. The NQCB should identify standardized measures that characterize the health and quality of care received by both individuals and populations. In general, the measures should not vary by type of health care provider or setting, but should characterize care across as well as within sites and settings. The set of standardized measures should provide the information needed to assess progress toward achieving the six quality aims and the national goals.

Principle 4: Supportive of Multiple Uses and Stakeholders

A national system for performance measurement and reporting should provide information for multiple uses, including provider-led improvement efforts, public reporting, payment and benefits design, and population health initiatives. This system should produce useful information for three purposes:

  • Accountability—Information should be available to assist stakeholders in making choices about providers, including patients identifying a clinician, hospital, or other provider from which to seek services; purchasers and health plans selecting providers to include in their health insurance networks; and quality oversight organizations making accreditation and certification decisions.

  • Quality improvement—The information provided should be of value to stakeholders responsible for improving the quality of care, including clinicians and administrators and governing board members of health care organizations.

  • Population health—The information should be useful for stakeholders making decisions about access to services (e.g., public insurance benefits and coverage); those involved in communitywide programs and efforts to address racial and ethnic disparities and promote healthy behaviors; and public officials responsible for disease surveillance and health protection.

Principle 5: Measurement Intrinsic to Care

Performance measurement should be intrinsic to the care process. For most standardized measures (e.g., health care processes and some outcome



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