Topic 5: Outcome Measures Vs. Process Measures

Topic 5: Outcome Measures Vs. Process Measures

Benchmark – Outcome and Process Measures

Continuous Quality Improvement (CQI) is a planned organizational process to promote the continuous step-by-step improvement of clinical processes, patient care, and safety. Health providers plan and execute continuous practical improvements in patient care processes to achieve quality health care outcomes (McCalman et al., 2018). CQI aims to improve operations, systems processes, outcomes, and the work environment. CQI processes involve defining the issue, benchmarking, establishing a goal, followed by repeated quality improvement projects.  In this regard, this paper seeks to discuss process and outcome measures that can be employed for CQI, describe data collection for each measure, and solutions to the challenge.

Process Measures

Process measures are the particular interventions in a practice that contribute to a specific metric either positively or negatively. They denote the evidence-based interventions and best practices that a healthcare organization implements

to better patient care quality (Jazieh, 2020). Process measures signify what an organization or health providers do to improve or maintain clients’ health. They reflect the accepted clinical practice recommendations. Besides, they are used to establish the root cause of a problem in a health organization (Jazieh, 2020). Process measures that can be used for a CQI include the percentage of patients who are provided with discharge education and the percentage of elderly and frail patients who undertook a fall risk assessment.

Outcome Measures

Outcome measures are vital clinical and financial outcomes relevant to healthcare organizations. They are quality and cost targets that health organizations aim to promote improvement (Jazieh, 2020). Outcome measures indicate the effect of patient care interventions or health services on the health status of patients. An example of an outcome measure for a CQI is readmission rates.

Why Each Measure Was Chosen

 In the process measures, the metric on the percentage of patients provided with discharge education was selected because it influences patients’ self-care at home and health outcomes in the post-discharge phase. Discharge education provides patients and their families with essential information needed to effectively manage their health at home (Newnham et al., 2017). Lack of or inadequate discharge education is associated with ineffective self-care and lifestyle modification resulting in high emergency visits, readmissions, or comorbidities, which worsen the health outcomes. Newnham et al. (2017) assert that discharge education is mandated by the Joint Commission and Centers for Medicare and Medicaid Services (CMS) as essential measures for an organization to meet requirements for accreditation and public reporting.

The percentage of elderly and frail patients who undertook a fall risk assessment was selected because falls are a major cause of morbidity and prolonged patient stays. Providers must take measures to assess patients’ risk of falls in order to employ the appropriate measures to prevent falls (Slade et al., 2017). A fall risk assessment classifies a patient as a low, moderate, or high fall-risk. Therefore, every hospitalized elderly patient requires an assessment to establish the interventions to be instituted to prevent falls and subsequent injuries.

Readmission rates was selected as an outcome measure because they are costly yet preventable. Readmission rates reflect the quality of care provided in an organization. Thus, high readmission rates indicate a substandard quality of care, while low rates reflect high quality (Upadhyay et al., 2019).  Readmissions create a high burden to healthcare organizations and patients. In the United States, almost 20% of patients on Medicare get a readmission within 30 days after discharge, resulting in high costs of approximately $17billion annually (Upadhyay et al., 2019). Therefore, Efforts to reduce readmission rates in a hospital through CQI programs can save patients and healthcare organizations huge costs and promote better healthcare outcomes.

How Data Would Be Collected for Each Measure

The data on the patients provided with discharge education will be collected from patient electronic health records (EHR) and questionnaires. The EHR contains a patient’s discharge summary, which contains the patient’s diagnosis, diagnostic findings, hospital treatment, and planned follow-up (Newnham et al., 2017). The discharge summaries will be used to identify the number of hospitalized patients provided with discharge education. In addition, patients will be administered questionnaires to collect information on whether a patient was provided discharge education, if they understood the instructions and if they find the instructions helpful or unhelpful. Data on the percentage of elderly and frail patients who undertook a fall risk assessment will also be collected using the EHR. An EHR-based fall risk assessment tool will be used to evaluate how many patients were assessed and the prevention interventions taken by providers (Slade et al., 2017). Readmission rates data will be collected from patients’ health records and the hospital database. The data will include the number of readmitted patients within 30 days after discharge.

Explanation of How Success Would Be Determined

 The success of the metric on the percentage of patients provided with discharge education will be determined by increased efforts by providers in providing timely and relevant discharge education. It will also be determined by having discharge summaries indicating the patient education provided to a patient before discharge. In addition, the success of the metric on the percentage of elderly and frail patients who undertook a fall risk assessment will be determined by having an increased number of filled risk assessment tools. Success on the readmission rates will be determined by having a reduced number of patients readmitted within 30 days, one year after a CQI project was initiated.

Data-Driven, Cost-Effective Solutions

High readmission rates can be addressed by improving care coordination and communication of patient care. Effective communication of patients’ health information is crucial to ensure patients are not readmitted. Patients must be conversant with their treatment plans as they move from the hospital settings to their homes, and this necessitates care coordination and communication among providers (Hoyer et al., 2018). However, using different health IT systems is a major barrier to care coordination. Health providers participating in patients’ care coordination can use health information exchanges (HIEs), which enable providers to receive patients’ information from different organizations and enhance their care management (Hoyer et al., 2018). Improved communication and care coordination is proven to lower readmission rates and, eventually, healthcare costs.


Process measures signify what an organization or health providers do to improve or maintain clients’ health. On the other hand, outcome measures signify the effect of the patient care interventions on their health status. The selected process measures include the percentage of patients provided with discharge education and the percentage of elderly and frail patients who undertook a fall risk assessment. The selected outcome measure is readmission rates since it reflects the quality of healthcare delivered by health providers. Improved care coordination and communication can help reduce readmission rates.


Hoyer, E. H., Brotman, D. J., Apfel, A., Leung, C., Boonyasai, R. T., Richardson, M., Lepley, D., & Deutschendorf, A. (2018). Improving Outcomes After Hospitalization: A Prospective Observational Multicenter Evaluation of Care Coordination Strategies for Reducing 30-Day Readmissions to Maryland Hospitals. Journal of general internal medicine33(5), 621–627.

Jazieh, A. R. (2020). Quality Measures: Types, Selection, and Application in Health Care Quality Improvement Projects. Global Journal on Quality and Safety in Healthcare3(4), 144-146.

McCalman, J., Bailie, R., Bainbridge, R., McPhail-Bell, K., Percival, N., Askew, D., Fagan, R., & Tsey, K. (2018). Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes. Frontiers in public health6, 76.

Newnham, H., Barker, A., Ritchie, E., Hitchcock, K., Gibbs, H., & Holton, S. (2017). Discharge communication practices and healthcare provider and patient preferences, satisfaction and comprehension: a systematic review. International Journal for Quality in Health Care29(6), 752-768.

Slade, S. C., Carey, D. L., Hill, A. M., & Morris, M. E. (2017). Effects of falls prevention interventions on falls outcomes for hospitalized adults: protocol for a systematic review with meta-analysis. BMJ Open7(11), e017864.

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry: a journal of medical care organization, provision, and financing56, 46958019860386.


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Topic 5: Outcome Measures Vs. Process Measures

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I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

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Please read through the following information on writing a Discussion question response and participation posts.

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Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

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  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource