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Evaluating Process & Outcome Metrics: Quality

Objective Learn how to design a measurement approach to systematically measure dimensions of quality in clinical care systems.
Date April 1, 2011
Lecturer

Lisa Hirschhorn, MD MPH
Associate Director of International Monitoring and Evaluation, Department of Global Health and Social Medicine, Harvard Medical School
Senior Clinical Advisor, HIV/AIDS, JSI Research and Training Institute

Lecture

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Readings

  1. Hirschhorn, L. R., B. Ojikutu, and W. Rodriguez. "Research for Change: Using Implementation Research to Strengthen HIV Care and Treatment Scale-Up in Resource-Limited Settings." Journal of Infectious Diseases 196 Suppl 3 (2007): S516-S522.
  2. Hirschhorn, L. R. "Ensuring Quality of Care in the Scale-up of HIV Care and Treatment in Resource-Limited Settings: A Challenge for All." Future Medicine 4, no. 6 (November 2007): 737-744.
  3. DeGroff, A., et al. "Ensuring Quality of Care in the Scale-up of HIV Care and Treatment in Resource-Limited Settings: A Challenge for All." Evaluation and Program Planning 33 (2010): 365-372.
  4. Brook, Robert H., Elizabeth A. McGlynn, and Paul D. Cleary. "Quality of Health Care: Part 2: Measuring Quality of Care." New England Journal of Medicine 335, no. 13 (1996): 966-970.
  5. McGlynn, Elizabeth A., and Steven M. Asch. "Developing a Clinical Performance Measure." American Journal of Preventive Medicine 14, no. 3 supplementary (1998): 14-21.
  6. Smits, Helen L., Sheila Leatherman, and Donald M. Berwick. "Quality Improvement in the Developing World." International Journal for Quality in Health Care 14, no. 6 (2002): 439-440.
  7. Donabedian, Avedis. "The Quality of Care: How can it be Assessed?" JAMA 260, no. 12 (1988): 1743-1748.

Supplemental Readings on General Quality Improvement Concepts in Resource-Limited settings

  1. Heerey, Michelle, Alice Payne Merritt, and Adrienne J. Kols. "Improving the Quality of Care: Quality Improvement Projects From the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs." Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Center Publication No. 101 (February 2003). (This resource may not render correctly in a screen reader.PDF)
  2. Quality Assurance Project, University Research Co., LLC
  3. HIVQUAL International (HIV only)
  4. Øvretveit, John. "Formulating a Health Quality Improvement Strategy for a Developing Country." International Journal of Health Care Quality Assurance 17, no. 7 (2004): 368-376.

Discussion Questions

  1. What are the dimensions of quality critical to measure in the context of clinical care systems?
  2. What are the attributes of a robust clinical quality measure?
  3. What are the critical components for a feasible and effective quality measurement system in resource limited settings?
  4. How is quality measurement useful for quality improvement and overall program monitoring and evaluation?