PT  - JOURNAL ARTICLE
AU  - Richard A. Young
AU  - Richard G. Roberts
AU  - Richard J. Holden
TI  - The Challenges of Measuring, Improving, and Reporting Quality in Primary Care
AID  - 10.1370/afm.2014
DP  - 2017 Mar 01
TA  - The Annals of Family Medicine
PG  - 175--182
VI  - 15
IP  - 2
4099  - http://www.annfammed.org/content/15/2/175.short
4100  - http://www.annfammed.org/content/15/2/175.full
SO  - Ann Fam Med2017 Mar 01; 15
AB  - We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear mechanical systems, such as isolated single-disease care, are inappropriate for nonlinear, complex adaptive systems, such as primary care, because of differences in care processes, outcome goals, and the validity of summative quality scorecards. Our priorities for primary care quality management include patient-centered reporting; quality goals not based on rigid targets; metrics that capture avoidance of excessive testing or treatment; attributes of primary care associated with better outcomes and lower costs; less emphasis on patient satisfaction scores; patient-centered outcomes, such as days of avoidable disability; and peer-led qualitative reviews of patterns of care, practice infrastructure, and intrapractice relationships.