Quality measurement

Abstract

Achieving the best outcomes for persons receiving healthcare or support services is a shared goal of the persons served and their families and friends, clinicians, direct support workers, administrators, payers, policymakers and researchers. Yet each of these interested parties bring different perspectives when defining, measuring and prioritizing outcomes. In this Special Communication we describe and define key quality measurement concepts, frameworks and terminology used in the Centers for Medicare & Medicaid Services' quality programs. We describe commonly used frameworks, including Donabedian's framework, the Institute of Medicine's aims of healthcare as detailed in Crossing the Quality Chasm, and a modification of the National Quality Forum's conceptual framework for high-quality home and community-based services. We also define the terms 'quality,' 'quality measure,' 'outcome measure,' 'performance measure,' and 'risk adjustment.' This information is intended to help readers better understand quality measurement terminology used by the Centers for Medicare & Medicaid Services. We hope that this information will support productive communication among interested parties about quality measurement in ways that advance quality in inpatient rehabilitation facilities and home and community-based services.