Don't forget process indicators

Process refers to how the physician delivers care. For example, a good process indicator for a hospital that provides acute myocardial infarction (AMI) services might be the time it takes to begin a catheterization procedure, or the so-called “door-to-wire” time. Why? Because clinical studies show that the quicker this procedure is performed, the better the quality of care as defined by myocardial preservation.

Why measure the process and not just measure the outcome? One reason is that measuring a process is often easier because it occurs in the present and at the hospital. An outcome, on the other hand, may occur at some distant time or place. For example, because of short hospital stays, inpatient surgical wound infections often are not detected until after patients are discharged. Obtaining this outcome data from each surgeon’s office would be quite difficult. However, studies show that timely preoperative prophylactic antibiotics reduce infection, so measuring the performance of the process of giving timely prophylactic antibiotics gives a good indication of the likelihood of fewer infections.

Process indicators can be very attractive to quality professionals because they are often easy to measure and lend themselves to statistical process control techniques. But there should be reasonable evidence that a process is connected to some important outcome to make it worth measuring—simply assuming the connection is not enough. Good process indicators measure processes that link to the desired outcome.

Source: Performance Indicators: Clinical Specialty–Specific Strategies and Samples