The changing nature of today's health care organizations, including pressure to reduce costs, improve the quality of care and meet stringent guidelines, has forced health care professionals to re-examine how they evaluate their performance. While many health care organizations have long recognized the need to look beyond financial measures when evaluating their performance, many still struggle with what measures to select and how to use the results of those measures. Because a growing number of health care professionals have readily adopted quality concepts, health care organizations should be able to quickly improve their performance measurement systems by following a few simple rules.

History

A brief look at the evolution of quality in modern health care systems may help understand the need to improve performance measurement.

More than 30 years ago, a physician named Avedis Donabedian proposed a model for assessing health care quality based on structures, processes and outcomes. He defined structure as the environment in which health care is provided, process as the method by which health care is provided, and outcome as the consequence of the health care provided. As a result, process management is limited, and often temporary, when the structure isn't also improved.

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