The importance of performance evaluation in implementation of the DialysisOutcomes Quality Initiative Guidelines

To determine the extent to which actual practices become more consistent ov er time with those advocated in Dialysis Outcomes Quality Initiative Guidel ines, clinical performance measures (CPMs) that are based on the DOQI Guide lines will need to be developed and implemented. CPMs also can be used to e valuate the effectiveness of interventions that are undertaken to promote c ompliance with specific Guideline recommendations, to validate DOQI Guideli nes that were based in whole or in part on expert opinion, and to protect a gainst erosion of the quality of care delivered to end stage renal disease patients that could occur as a result of economic pressures. To achieve the se goals, CPMs must be valid, reliable, and practical to use. A federally s ponsored effort to develop such CPMs is currently underway This report pres ents an overview of CPMs and the challenges involved in developing technica lly sound specifications for CPMs that are based on DOQI guidelines. (C) 19 99 by the National Kidney Foundation, Inc.