From the Guidelines
Quality indicators in healthcare are crucial for evaluating the quality of patient care and health services, and they include structure, process, and outcome measures, as well as patient-centeredness, equity, efficiency, effectiveness, safety, and timeliness, as outlined in the Donabedian model and the Institute of Medicine’s 6 Domains of Health care Quality 1.
Key Quality Indicators
Some key quality indicators in healthcare include:
- Patient safety measures, such as medication error rates, hospital-acquired infection rates, and surgical complications
- Clinical effectiveness metrics, like mortality rates, readmission rates, and adherence to evidence-based guidelines
- Patient experience measures, including satisfaction scores, wait times, and communication effectiveness
- Process indicators, which track how healthcare is delivered, such as hand hygiene compliance and appropriate antibiotic use
- Outcome indicators, which measure the results of care, such as functional improvement after treatment
Importance of Quality Indicators
Quality indicators are essential for benchmarking, identifying suboptimal aspects of care, and evaluating, monitoring, and comparing performance across providers, clinical settings, and jurisdictions 1. They help healthcare providers identify areas for improvement, track progress over time, and ensure they are delivering high-quality care that meets established standards.
Recent Developments
Recent studies have developed quality indicators for specific conditions, such as heart failure, to evaluate the quality of care and outcomes for adults with heart failure 1. These indicators are designed to be relevant to specialist and contemporary care, and applicable to European healthcare systems.
Implementation
The implementation of quality indicators is critical for continuous quality improvement and maintaining patient-centered care. Regular monitoring of these indicators is essential to identify areas for improvement, track progress, and ensure that healthcare providers are delivering high-quality care that meets established standards. Healthcare organizations should prioritize the use of quality indicators to evaluate and improve the quality of patient care and health services, as outlined in the most recent and highest quality study 1.
From the FDA Drug Label
The primary endpoints of the trial were (1) all-cause mortality plus all-cause hospitalization (time to first event) and (2) all-cause mortality. The FDA drug label does not answer the question.
From the Research
Quality Indicators in Healthcare
Some quality indicators in healthcare include:
- Hospital clinical indicators, such as infection, safety, quality, and mortality domains 2
- Readmission rates, which can be used for quality improvement and cost control, but have methodological concerns that need to be addressed 3
- Patient Safety Indicators (PSIs) and Hospital-acquired Conditions (HACs), which are used for pay-for-performance and public reporting, but have limited validity when measured against medical chart reviews 4
- Hospital mortality rates, emergency department length of stays, and readmission rates, which are currently used to measure quality, but have limitations and focus on provider and process issues rather than patient outcomes 5
Classification of Quality Indicators
Quality indicators can be classified according to Donabedian's structure, process, and outcome model, and in specific domains such as:
- Quality
- Safety
- Infection
- Mortality 2
Limitations of Quality Indicators
There are several limitations to the use of quality indicators in healthcare, including:
- Methodological flaws, such as unreliable data and insufficient case-mix correction, which can confound the comparison of readmission rates between hospitals 3
- Limited validity of PSIs and HACs when measured against medical chart reviews 4
- Focus on provider and process issues rather than patient outcomes 5
- Coding errors, which can be a common reason for discrepancies between medical record review and administrative databases 4