How can trusts measure quality well?

Measuring quality was rightly put at the forefront of quality improvement by the NHS Next Stage Review. But we need to get better at thinking about why we want to measure something and how we will use that information to improve care if we are going to develop a truly sophisticated and intelligent approach to quality measurement in the NHS.

For some purposes, such as quality accounts, we need clearly comparable data over time, to compare organisations' performance and see how they improve.

But for day-to-day monitoring of care in a clinical setting, we need more real-time measures collected at the point of care. And whatever the purpose, we need to provide contextual information so that the users of the data understand what it is – and isn't – telling them about the real quality of care.

Last week we held a workshop to stimulate discussion and get feedback on the proposed content of a discussion paper on quality measurement, due to be published in early 2010.

The speakers gave a range of perspectives – government, provider, commissioner, GP and patient – which was useful in unpacking what measuring quality means to different parts of the system.

Support was unanimous for using quality measurement as a tool for improvement, particularly highlighting the need for clinical engagement, clarity of aims, good quality data and rigorous analysis, and for indicators that cover patient pathways across organisational boundaries.

There was also an endorsement for 'less is more' in terms of indicators, and for linking quality measurement to productivity and efficiency measures. Views were less consistent about how quality should be defined and measured, and about the number and complexity of indicators.

What do you think is the key to measuring quality well? Let us know by adding your comments below.