No Clear Standard For Measuring Health Care Quality Improvement Interventions

Megan Colleen McHugh, PhD Research Assistant Professor Center for Healthcare Studies Institute for Public Health and Medicine and Emergency Medicine Northwestern Interview with:
Megan Colleen McHugh, PhD
Research Assistant Professor
Center for Healthcare Studies
Feinberg Institute for Public Health and Medicine and Emergency Medicine
Northwestern University

Medical Research: What is the background for this study? What are the main findings?

Dr. McHugh: There have been many large efforts to improve the delivery of health care in the U.S., for example, the Robert Wood Johnson Foundation’s Aligning Forces for Quality Program and the Institute for Healthcare Improvement’s 100,000 Lives Campaign.  One of the challenges to understanding whether these programs work is that the intervention “dose” – the quality and quantity of the intervention – often varies across different participating sites.

As evaluators of multi-site quality improvement programs, we want to better understand how to measure the dose of a quality improvement intervention at participating sites.  We identified four different approaches to measuring dose.  These approaches resulted in different conclusions about which sites are “low dose” and “high dose” intervention sites.

Medical Research: What should clinicians and patients take away from your report?

Dr. McHugh: The main audience for this paper is program evaluators.  They should take away the following:

1) Variation in dose scores across intervention sites suggests that dose may be a contributor to the effectiveness of a quality improvement intervention.

2) It is feasible to measure the dose of a quality improvement intervention, but measuring QI dose presents many challenges, including subjective decisions about which approach to measurement to use and the need for extensive data collection.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. McHugh: Although we are confident that the dose of quality improvement interventions is important to understand, there is still no widely accepted method for measuring it.  There is a need for greater dialogue among researchers about how to measure the dose of quality improvement interventions.

Also, while there is an assumption that intervention dose can influence program outcomes, empirical evidence is limited.  Further study is needed to investigate the link between quality improvement dose and outcomes.


Measuring the Dose of Quality Improvement Initiatives.

McHugh M1, Harvey JB2, Kang R3, Shi Y4, Scanlon DP4. is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional.

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Megan Colleen McHugh, PhD (2015). No Clear Standard For Measuring Health Care Quality Improvement Interventions 

Last Updated on September 12, 2015 by Marie Benz MD FAAD