DEVELOPING A CLINICAL-PERFORMANCE MEASURE

Background: Clinical performance measurement is an increasingly import ant way for public and private purchasers alike to compare the value o f health services provided by competing health delivery systems. The w idespread use of performance measures has increased the demand for dev elopment of new measures that cover previously unevaluated aspects of care. Methods: Four steps required to develop a clinical performance m easure that is suitable for-making comparisons among health delivery s ystems are discussed: (1) choosing clinical areas to measure, (2) sele cting performance indicators within each area, (3) designing specifica tions for consistent implementation of a measure, and (4) evaluating t he scientific strength of a measure, Results: The application of these steps to developing measures of quality for hyper-tension is provided , with an emphasis on a measure of adequacy of control of blood pressu re. Conclusions: Developing useful clinical performance measures requi res careful attention to methodologic issues, Following the steps outl ined in this paper should enhance the quality of future measurement de velopment. (C) 1998 American Journal of Preventive Medicine.