Quality improvement in New Zealand healthcare. Part 4: achieving effective care through clinical indicators
Buchanan, J.; Pelkowitz, A.; Seddon, M.
New Zealand Medical Journal 119(1240): U2131
2006
ISSN/ISBN: 1175-8716 PMID: 16924282 Document Number: 597097
Clinical indicators can be a powerful means of improving the effectiveness of patient care. In this fourth article in the Series on quality improvement we identify the key attributes of clinical indicators and provide a scheme for their critical appraisal. Clinical indicators are objective measures of the process or outcome of patient care. They can be used to monitor care; to flag potential opportunities to improve care, and to provide evidence that a change in practice has resulted in improvement. Clinical involvement from the "bottom up" helps to ensure that indicators are used in a formative way with a focus on "quality improvement," rather than as a summative mechanism for "top-down" external accountability which attempts to "assure" quality. In some cases, such external quality assurance can actually harm quality improvement efforts.