International Journal for Quality in Health Care Advance Access originally published online on December 13, 2006
International Journal for Quality in Health Care 2007 19(1):1-3; doi:10.1093/intqhc/mzl066
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International Journal for Quality in Health Care vol. 19 no. 1 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Editorial |
All or none measurement: why we know so little about the comprehensiveness of care
| The first 150 words of the full text of this article appear below. |
In a recent article published in JAMA, All or None Measurement Raises the Bar on Performance, Nolan and Berwick describe the methods used by the Institute for Healthcare Improvement (IHI), the US National Healthcare Reports, the Joint Commission on Accreditation of Healthcare Organizations, the National Committee for Quality Assurance, and other organizations to examine care across a set of measures [1]. This approach, to state it simply, looks at data at the patient level to examine whether a bundle or set of evidence-based interventions that are supposed to be done for the patient are actually done for the patient. The all or none approach, as Berwick and Nolan point out, has the tremendous advantage of offering a more complete picture of care across a range of aspects of quality for specific conditions. However, there are a number of practical limitations to this method which have been inadequately explored
Background
Key limitations of all or none measurement
Conclusions
Head, Health Care Quality Indicators Project, Organization for Economic Cooperation and Development and Director, US National Healthcare Reports, US Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA E-mail: edward.kelley@ahrq.hhs.gov