ABSTRACT
Measurements to assess the quality of care have been available to health care professionals for many years. Measures of care, such as mortality rate, and measures of morbidity, such as infection rate or transfusion rate, long have been collected as a part of quality assurance or utilization programs. Most of these programs were designed either to find errors in medical practice or to ensure compliance with accepted standards of care, often as requirement for accreditation. Systems to monitor and improve the quality of health care in managed care organizations traditionally have included internal quality assurance programs, external quality review, and published standardized performance reports. It increasingly has become important for health system managers to focus on quality management and to look at other industries for proven quality management techniques that can be applied in the health care setting. Quality indicators or performance measures need to be periodically reevaluated as to their appropriateness and utility in improving care in the organization.
