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Toward Quality Measures for Population Health and the Leading Health Indicators (2013)

Chapter: Appendix B: Sample Criteria Consulted

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Suggested Citation: "Appendix B: Sample Criteria Consulted." Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press. doi: 10.17226/18339.

Sample Criteria Consulted

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TABLE B-1 Previously Published Criteria for Selected Groups of Measures

Category for Criteria	NQF, 2012: Measure evaluation criteria: Criteria for evaluation once measure meets criteria for consideration (NQF, 2012b)	HHS SAC, 2011: Operation criteria for selection of LHIs (HHS, 2008, 2013)	IOM, 2010: Future directions for the national quality Criteria for selecting measures (IOM, 2010)	IOM, 2003b: Priority areas for National Action Criteria for identifying priority areas for health care quality efforts (IOM, 2003)
Criteria that apply to the condition(s) or outcome(s) to be measured
Impact (Importance)	• Impact: Priority (measure addresses identified priority or has high impact on patients)	• Central: important as a determinant of health status • Instinctive: easily recognized as intimate to health status • Immutable: convey a sense of the obligation to act	• Importance: high-impact based on potential population impact, high cost, variation in quality, low performance levels, or existing disparities • Applicability to national priorities: Does it measure progress in at least one of the national priority areas for improving the quality of health care and eliminating disparities?	• Impact: the extent of the burden—disability, mortality, and economic costs—imposed by a condition, including effects on patients, families, communities, and societies. • Inclusiveness: the relevance of an area to a broad range of individuals with regard to age, gender, socioeconomic status, and ethnicity/race (equity) ... and the breadth of change effected through such strategies across a range of health care settings and providers (reach).

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Improvability

• Impact: opportunity for improvement (i.e., performance gap)• Impact: evidence (measure focus is health outcome or is evidence-based)• Usability and use: extent to which potential audiences are using or could use performance results for both accountability and performance improvement

• Actionable: convey a sense of the possibility to act

• Improvability: is there evidence (not limited to RCTs) that improvement can be made?• Value: does the measure have the potential to increase health care value by narrowing a defined quality gap?• If criteria are met, select measure for use based on its ranking to improve population health and equity

• Improvability: the extent of the gap between current practice and evidence-based best practice and the likelihood that the gap can be closed and condition improved through change in an area; and the opportunity to achieve dramatic improvement in the six national quality aims identified in the Quality Chasm report (safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity).• Inclusiveness: the generalizability of associated quality improvement strategies to many types of conditions and illnesses across the spectrum of health care (representativeness); and the breadth of such strategies across a range of health care settings and providers (reach).

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TABLE B-l

Category for Criteria	NQF, 2012: Measure evaluation criteria: Criteria for evaluation once measure meets criteria for consideration (NQF, 2012b)	HHS SAC, 2011: Operation criteria for selection of LHIs (HHS, 2008, 2013)	IOM, 2010: Future directions for the national quality Criteria for selecting measures (IOM, 2010)	IOM, 2003b: Priority areas for National Action Criteria for identifying priority areas for health care quality efforts (IOM, 2003)
Criteria that apply to the condition(s) or outcome(s) to be measured
Scientific soundness	• Validity• Reliability: measure is well defined and precisely specified and produces same results when repeated• Comparison to related measures to ensure harmonization		• Sound measure available: Have scientifically sound measures been developed to assess this area?

Geographic, temporal, and population coverage		• Divisible: into key sub-populations• Translatable: to the national, state, community, and individual levels• Measurable: at a point in time, over time	• Equity: does the measure document significant inequities in care by race, ethnicity, language need, or socioeconomic status?• Geographic and health systems equity: does the measure document	• Inclusiveness: the relevance of an area to a broad range of individuals with regard to age, gender, socioeconomic status, and ethnicity/race (equity) … and the breadth of change effected through such strategies across a range of health care settings and providers (reach).

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		geographic or health system variation in performance?

Data availability	• Feasibility: data are readily available or could be captured without undue burden and can be implemented for performance measurement	• Data availability: Does an appropriate national data source exist that would support assessment of performance overall as well as among disparity populations?