Defining and classifying clinical indicators for quality improvement

Mainz, Jan

The National Indicator Project and University of Aarhus, Denmark

Address reprint requests to J. Mainz, The National Indicator Project, University of Aarhus, Lyseng Allé 1, 8270 Hoejbjerg, Denmark. E-mail: [email protected]

Accepted for publication 7 August 2003

International Journal for Quality in Health Care 15(6):p 523-530, December 2003.

Objective

This paper provides a brief review of definitions, characteristics, and categories of clinical indicators for quality improvement in health care.

Analysis

Clinical indicators assess particular health structures, processes, and outcomes. They can be rate- or mean-based, providing a quantitative basis for quality improvement, or sentinel, identifying incidents of care that trigger further investigation. They can assess aspects of the structure, process, or outcome of health care. Furthermore, indicators can be generic measures that are relevant for most patients or disease-specific, expressing the quality of care for patients with specific diagnoses.

Conclusions

Monitoring health care quality is impossible without the use of clinical indicators. They create the basis for quality improvement and prioritization in the health care system. To ensure that reliable and valid clinical indicators are used, they must be designed, defined, and implemented with scientific rigour.