A clinical quality measures rubric outlines actions developers can take to make measures more patient-centered.
As value-based care continues to take hold of the medical industry, it will be essential for healthcare policymakers to establish clinical quality measures that are patient-centered and meaningful for patients and caregivers, according to a new guidance from the Pharmacy Quality Alliance (PQA).
The guidance, taking the form of a Patient Engagement in Quality Measurement Rubric, aims to instruct healthcare policymakers and quality measure developers in how to integrate the patient voice into clinical quality measures.
Clinical quality measures are the crux of value-based care, which provides reimbursement for providers on the grounds that providers meet certain clinical quality benchmarks. But as more medical professionals acknowledge the importance of positive patient experiences and patient perceptions of care, policymakers are facing a call to design patient-centered quality measures.
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“Strong quality measures require the perspectives of the patient community, whose health care experiences and outcomes are the ultimate goal of all quality improvement efforts,” Laura Cranston, RPh, the CEO of PQA, said in a statement. “We’re pleased to have developed a rubric that provides guidance for meaningful engagement of the patient community in the measure lifecycle. The quality measurement experts, patient advocates, caregivers and patients who created this tool have made a tremendous contribution to our national effort to transform our health care system into a patient-centered enterprise.”
The rubric, created in partnership with the National Health Council and the National Quality Forum with support from Merck & Co., specifically aims to put the patient voice into quality measures development at each step of the way. In doing so, PQA and its partners hope to create a healthcare system that works well for the patient.
“By ensuring the patient and caregiver communities are involved from the start of the quality-measurement process, we will develop measures that are meaningful to the patient and that measure what is most important to them,” said Eleanor Perfetto, PhD, MS, executive vice president of Strategic Initiatives at NHC.
The rubric can be used at any point during the quality measure development process, the authors said. This includes measure conceptualization, development, implementation, and use or evaluation.
And during each of those phases, measure developers should focus on key aspects of patient-centricity, such as patient partnership, transparency, representativeness, and meaningfulness, the authors said. Certain efforts at each phase of the development process can ensure each of those four patient engagement pillars are met.
For example, creating a mechanism to recruit patients in measure design can help ensure patient partnership, the authors wrote. Developers need to train staff in engaging patients, provide meaningful patient education materials to engage patients and community in quality measurement, as well.
Measure transparency will require developers to consistently report on their efforts to integrate the patient voice and to justify areas where they make certain decisions. Decisions to include certain populations in measure development over others, for example, would warrant justification, the team said.
Additionally, giving patients the information necessary to make informed opinions about certain clinical quality measure proposals will also be essential to providing transparency to patients. Developers must obtain consistent patient and community feedback about the process.
Measure developers can account for representativeness by looking at the patient populations who may be impacted by a certain procedure to clinical experience. Including all of those populations during the development process will ensure developers obtain a diverse view of patient experiences. This will also prevent certain biases from seeping into clinical quality measures.
Finally, developers must engage patient partners during the entire measure development process and collect patient views using various surveying methods. This will ensure a diversity of patient views and help developers better understand just how meaningful certain measures will be to patients.
Measure developers can look at each of these areas and score them on a four-point scale, ranging from exhibiting the patient-centeredness principle all the way to low patient engagement. From there, measure developers should look at the different engagement activities listed above that may help drive patient activation in measure development.
Ultimately, these efforts should ensure more meaningful measures that could ideally facilitate a better patient experience. In understanding which outcomes would be ideal to patients and understanding which outcomes are important to them is at the crux of delivering valuable healthcare experiences.
“A foundational purpose of quality measures is to help individuals make important healthcare decisions,” concluded Kathleen Giblin, senior vice president of Quality Innovation at NQF. “Good quality measures come from understanding what patients and their caregivers really value and using those to drive better care.”
Date: October 04, 2019
Source: PatientEngagementHIT