What Are the Most Important Quality Metrics in Healthcare?

As a facility leader, you need to know how your organization is performing so that you can make informed decisions and steer your organization toward your identified goals. Quality metrics in healthcare are measurements that help providers understand how their systems for care delivery are performing. This data can be incredibly informative, especially when metrics are considered together, over time, to reveal patterns.

Used in this way, metrics can help leaders make judgments and facilitate better patient outcomes. We’ll discuss the most important quality indicators to use when assessing the overall performance of your organization, and describe how metrics are typically organized. We’ll also provide examples so that you understand how metrics can prompt improvement initiatives, guide decisions, and trigger innovations within organizations.

What Are Quality Metrics in Healthcare?

In healthcare settings, quality metrics (or quality indicators) are measurements that can be used to assess the caliber of care delivered. Metrics aren’t a perfect reflection of the quality of care because of the limitations involved, but they can provide a framework of data that points toward systemic shortcomings and successes. Metrics often take the form of a ratio, rate, rank, or percentage, and can be considered existing evidence of the safety and efficacy of the services offered to patients.

Types of Healthcare Quality Metrics

Quality metrics can be organized according to the structure-process-outcome (S-P-O) model, also known as the Donabedian model. This classification system identifies three interconnected areas of quality measures.

Structure

This category of metrics pertains to the organization’s physical and organizational infrastructure, and the systems in place for providing services.

Examples of structure measures in healthcare:

• The number of MRI machines on an organization’s campus
• The number of board certified physicians working at a facility
• Whether a facility is accredited by The Joint Commission (TJC)

Process

These metrics relate to the active delivery of evidence-based, quality care to patients, including tests, treatments, and other services.

Examples of process measures in healthcare:

• The percentage of eligible patients who received colorectal cancer screening
• The percentage of diabetic patients who received blood glucose testing

Outcome

Metrics in this category relate to the result of the care processes that took place.

Examples of outcome measures in healthcare:

• The percentage of patients receiving total knee replacement surgery who developed a surgical site infection
• A facility’s 30-day unplanned hospital readmission rate

Quality Metrics in Healthcare: Examples of Causal Chains

When considering your facility’s metrics, it’s important to understand the concept of causal chains — the sequential relationship between individual quality measurements. Let’s take a closer look at an example of three metrics that form a causal chain.

• Structural metric: A med-surg floor at a hospital uses a nurse-to-patient ratio of 1:8.
• Process metric: 40% of abdominal surgery post-operative patients received teaching from an RN about how to correctly use an incentive spirometer device within 4 hours of arriving on the unit.
• Outcome: 7.2% of abdominal surgery post-operative patients developed pneumonia within 7 days.

In our example, the facility’s availability of human resources (nurses) has a direct influence on the quality of nursing care provided, and ultimately impacts the patient outcomes. Causal chains can be monitored and analyzed over time to assess performance and the success of various quality improvement initiatives.

The 3 Most Important Quality Metrics

Tracking and monitoring data is an important aspect of your leadership duties. The widespread implementation of electronic health record (EHR) systems, often equipped with automated data extraction features, means that there’s more data available to administrators and managers than ever before. With so much information at your fingertips it may be difficult to discern which metrics are most important.

The exact metrics you work with will depend on your facility, patient population, and goals, as well as the federal and state quality standards your agency abides by. However, no matter what your situation, the three measurements we’ve highlighted below stand out as critical to track and assess.

In addition to explaining these big-hitter metrics we’ll also give you practical, real-world examples. Reading examples of quality metrics in healthcare settings similar to your own is an excellent way to get inspired to make positive changes at your facility.

1. Hospital-Acquired Infection (HAI) Rates

Many healthcare facilities track and monitor several distinct categories of hospital-acquired infections, which may include (depending on the patient population and services provided):

• Central Line-Associated Bloodstream Infections (CLABSI)
• Catheter-Associated Urinary Tract Infections (CAUTI)
• Surgical Site Infections (SSI)

These outcome measures provide helpful information about how the system is working as a whole. For example, a sudden, significant spike in any category can be indicative of failures in the structural and process categories of a facility’s functioning.

Real-world example: A neonatal intensive care unit (NICU) with a high CLABSI rate of 13.25 cases per 1,000 central line days implemented a quality improvement initiative and successfully brought the rate down to 4.85 cases per 1,000 central line days.

2. 30-Day Readmission Rates

This outcome measure can inform facility leadership about the healthcare team’s performance in multiple areas of care. High rates indicate that the facility may have delivered incomplete or ineffective interventions, or discharged their patients too early and with insufficient support in place. The Centers for Medicare and Medicaid Services tracks readmission rates and uses them to inform reimbursements and value-based incentives.

Real-world example: A medical center in New York City reduced 30-day readmissions by 43% in a high-frequency group of patients. This was accomplished with an initiative that included a new clinic that provided medical treatments, social work services, and counseling to the targeted patient group.

3. Patient Experience Survey Scores

Facility-issued patient surveys and standardized surveys (such as the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS) are used to collect data about the patient’s experience with a healthcare system. This data provides insights into a facility’s staff responsiveness, pain management protocols, environmental cleanliness, discharge planning practices, and more.

Real-world example: A medical center in Dallas noticed a low HCAHPS percentile ranks related to cleanliness. Leadership initiated a complete overhaul of the center’s cleaning and disinfecting program, which resulted in a higher HCAHPS percentile rank five years later.

Looking for More Healthcare Leadership Insights?

Learning from examples of quality metrics in healthcare is a great way to enhance your leadership abilities. Looking for more ways to grow as a leader, inspire your team, and improve your facility’s care delivery processes? Get practical healthcare leadership tips and insights that you can put into use today.