QUERI – Quality Enhancement Research Initiative

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Quality Improvement Methods

23. Key Performance Indicators

a. Definition: Quantitative measures of performance are considered essential to good quality and meeting an organization's goals. Metrics should include measurement of the important aspects of the healthcare system and various organizations have defined categories and specific measures to be calculated. Ideally any research proposed would be measureable by the KPI's that the organization has defined as important.

b. Literature:

  • Parmenter, David. Key performance indicators (KPI): developing, implementing, and using winning KPIs. John Wiley & Sons, 2010. Not specifically about healthcare but covers the KPI topic.
  • AHRQ Publication Evaluation of the Use of AHRQ and Other Quality Indicators: Final Contract Report. December 2007. This reports the uses of, market for, and demand for AHRQ and other Quality Indicators. (08-M012-EF)
  • Abujudeh, Hani H., et al. "Quality Initiatives: Key Performance Indicators for Measuring and Improving Radiology Department Performance." RadioGraphics 30.3 (2010): 571-580.
  • Pro, Douglas Doucette, and Bruce Millin Con. "Should Key Performance Indicators for Clinical Services Be Mandatory?." The Canadian Journal of Hospital Pharmacy 64.1 (2011). Sometimes there are conflicting objectives from various parts of an organization causing disagreement as to what should be measured.

c. Example: A research project envisioned improving patient care for a particular diagnosis. The patient outcomes before and after the intervention were to be measured. The researchers needed to be sure that the outcome measures they tracked, and were trying to improve, included key performance measures the organization currently followed. If the improvement did not impact any of the current KPI then ongoing use of the change may be less likely to be sustained. Some common KPI's are:

  • Timely administration and discontinuation of prophylactic antibiotics. As a KPI there would be a measurement of the frequency percentage or the raw quantity. Such a measure is helpful as an indicator of quality.
  • Participation in patient care rounds. Some measures are indicators of workload as well as the structure of the work.
  • Operational results such as patient throughput and room utilization.

d. Steps: Creation and implementation of Key Performance Indicators could follow the elements of PDSA or DMAIC as described in this handbook. The KPIs should be based on the purpose of the department or organization represented.