A hospital quality improvement committee is reviewing various metrics to evaluate patient safety initiatives. Match each clinical metric described below to its appropriate quality measure classification.
- The percentage of eligible patients who receive deep vein thrombosis prophylaxis within hours of admission.Process measure
- The number of board-certified intensivists available in the medical intensive care unit during night shifts.Structural measure
- The overall rate of catheter-associated urinary tract infections per catheter days.Outcome measure
- The incidence of healthcare-associated Clostridioides difficile infections after implementing a new broad-spectrum antibiotic protocol.Balancing measure
Answer
The correct matching aligns DVT prophylaxis administration with a process measure, intensivist staffing with a structural measure, the CAUTI rate with an outcome measure, and the tracking of C. difficile infections after an antibiotic change with a balancing measure.
According to the Donabedian model for quality of care, healthcare metrics are divided into structure, process, and outcome. Structural measures evaluate physical and organizational resources, such as staffing ratios and facility certifications. Process measures evaluate the clinical actions taken by providers, such as administering appropriate prophylaxis. Outcome measures evaluate the final effects on patient health, such as infection rates. Furthermore, contemporary quality improvement models incorporate balancing measures to ensure that an intentional change in one part of the system does not cause unexpected harm or inefficiency elsewhere.
Step-by-Step Solution
Key Concept
Donabedian Model of Care and Quality Improvement Metrics