Patient-Centered Quality & Performance Measurement
AIR works to bridge research and practice by adapting evidence-based theory to real-world settings and challenges. Current performance measurement approaches too often don’t align with patient and family needs, preferences, and values. When this happens, organizations run the risk of providing information that patients do not find relevant or useful when making care decisions. Health care organizations also can overlook ways to drive quality and safety improvements that matter to patients. Ultimately, to reorient the healthcare system to center on patients’ needs, preferences, and values, measurement must reflect what matters to patients.
With support from the Robert Wood Johnson Foundation, AIR has developed two sets of measurement principles. First, the Principles for Making Health Care Measurement Patient-Centered in real-world settings offer a vision of measurement that is patient-driven, holistic, transparent, comprehensible and timely, and co-created with patients. Second, the principles for shared measurement show how community members, system leaders, service providers, and policymakers actively engaged in cross-systems efforts can use shared measurement as a tool to align decisions, policies, and practices toward equitable health and well-being. While the contexts for their application differ, each of these sets of principles show that measurement is an important tool for building equitable systems because it works structurally to center systems’ actions on the needs and priorities of communities those systems aim to serve.
Over the last decade, AIR has led seminal work in developing patient-centered outcome and performance measures from patient-reported data. AIR’s measure specification, testing, implementation, and maintenance work for the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality (AHRQ), the American Society of Nephrology, and the National Institutes of Health includes an array of patient-reported measures, including:
- Care coordination
- Experience of care, such as Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys
- Health status and quality of life, such as the Patient-Reported Outcome Measurement Information System (PROMIS®) and the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me®)
- Population/community health
- Patient safety
- Person- and caregiver-centered experiences and outcomes
An example of AIR’s expertise across the full measure development lifecycle is the CAHPS Home- and Community-Based Services (HCBS CAHPS) Survey, which elicits feedback from Medicaid enrollees about the quality of the long-term services and supports they receive in the community. And in partnership with the Mayo Clinic, AIR developed the CAHPS Cancer Care Survey for AHRQ, which assesses the experiences of adult patients with cancer treatment provided in outpatient and inpatient settings, including independent community oncology practices, cancer centers at community hospitals, and cancer centers at academic medical centers.