Keys to Care Quality: Appropriateness of Care, Outpatient Safety Measures

While most outpatient quality measures focus on preventive care, chronic disease care, and patient experience, quality improvement efforts in the outpatient setting have not focused enough on the appropriateness or safety of care, states a viewpoint published online March 21, 2013, in JAMA. Currently used quality measures neglect critical areas of high-quality care, writes Tara Bishop, M.D., M.P.H., who suggests there is a need to develop measures of “high-level effectiveness” (e.g., diagnostic accuracy, judicious use of resources) and outpatient-specific patient safety measures. “Outpatient safety measures could be similar to 'never' events that have been defined for the inpatient setting,” suggests Bishop, who adds, “In the outpatient setting, 'never' events include prescribing errors that could lead to dangerous consequences; failure to inform patients of important test results; medical-setting acquired infections; and failure to properly monitor for adverse effects of treatments.”