HCA 603 - Measures

Exercise 17 Measures
Rubric of Measure Quality – Specific, measurable, timely, achievable, relevant.

Measures	Specific	Measurable	Timely	Achievable	Relevant
Patient Waiting Times	✔	✔	✔	✔	✔
Billing codes for PA services (Frequency, rate)	✔	✔	✔	✔	✔
Billing Cost of services	✔	✔			✔
Number of readmissions for previous complaints	✔	✔			✔
Number of electronic referrals	✔	✔	✔	✔	✔
Number of follow up or consultation visits	✔	✔	✔		✔

Specific

The indicator must be able to be translated into operational terms and made visible. While the outcome/result itself can be broad, the indicator should be narrow and focus on the ‘who’ and ‘what’ of the intervention. Additionally, ‘how’ and ‘where’ the ‘who’ is doing the ‘what’ is important to include in the indicator as it provides the action for the intervention. The data collected clearly and directly relates to the achievement of an objective and not to any other objective.

·       Is it clear exactly what is being measured?

·       Has the appropriate level of disaggregation been specified?

·       Does the indicator capture the essence of the desired result?

·       Does it capture differences across areas and categories of people?

·       Is the indicator specific enough to measure progress towards the result?

Measurable:

The indicator has the capacity to be counted, observed, analyzed, tested, or challenged. If one cannot measure an indicator, then progress cannot be determined.

How will one know if the outcome has been achieved? Once an indicator is clear and specific, they can be measured in numerous ways; almost any indicator is in one way or another, measurable.

Timely:

Indicators must be timely in several aspects. First, they must be timely in terms of the time spent in data collection. This relates to the resources that are available - staff and partner time being critical. Second, indicators must reflect the timing of collection. Finally, the time-lag between output delivery and the expected change in outcome and impact indicators must also be reflected in the indicators that are chosen.

Time-Bound, Timely, Trackable, and Targeted: The system [monitoring and evaluation system and related indicators] allows progress to be tracked in a cost-effective manner at the desired frequency for a set period, with clear identification of the particular stakeholder group(s) to be affected by the project or program.

Achievable and Attributable:

The system [monitoring and evaluation system and related indicators] identifies what changes are anticipated as a result of the intervention and whether the results are realistic. Attribution requires that changes in the targeted developmental issue can be linked to the intervention.

Relevant:

An indicator should be a valid measure of the result/outcome and be linked through research and professional expertise. The best way to think about relevance is to ensure that there is a relationship between what the indicator measures and the theories that help create the outcomes for the client, program, or system. The best method to find relevant indicators is to consult expert input and proper research.

Measures	Specific	Measurable	Timely	Achievable	Relevant
Patient Waiting Times	Minutes per visit	Time duration calculations by EHR	Easy to acquire through EHR	Reduction of patient waiting times	Decreased waiting times allows for more patient visits
Billing codes for PA services (Frequency, rate)	Frequency of specific CPT codes	Codes tracked by both EHR and Insurances	Easy to acquire from EHR and insurance	Easy to achieve specific	PA services related to specific CPTs
Billing Cost of services	Insurance Price linked to CPT code	Costs linked to insurance – vary depending on specific insurances	Task will be difficult due to maze of pricing via different insurance	The cost comparison will be difficult owing to insurance	Cost is a huge factor of promoting APPs.
Number of readmissions for previous complaints	Patient visits for same complaints	Readmissions for specific complaints tracked	Will be difficult to track readmissions at different healthcare sites	Tracking down admissions for patients at different sites will be difficult	Necessary to answer APP vs MD quality
Number of electronic referrals	EHR logs of referrals	Referrals tracked for specialists visits	Same procedure done as usual	Referrals easy to track and provide	Less referrals for preventative health
Number of follow up or consultation visits	EHR logs of follow ups/consults	Consultations and follow ups tracked	Same procedures done as usual	Easy to track using EHR	Follow ups necessary aspect of preventative health