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22 Commonly Used Quality Performance Measures In Healthcare

Track these popular quality measures in healthcare to give your organization a wellness check.

As a ClearPoint Senior Consultant, Rachel works with ClearPoint customers to improve their performance management and strategy execution.

Wellness checks aren’t just for people—even healthcare systems themselves can benefit from regular evaluations of “fitness” levels. But hospitals and clinics must conduct these evaluations while continuously facing new challenges, such as the rising demand for care, shifting policies, and uncertain legislation, and of course, COVID-19. Tracking quality measures in healthcare facilities is the best way to evolve business models because these measures:

  • Use data to assess improvement and progress, while holding facilities accountable to specific goals.
  • Foster better, more strategic decisions based on quantitative and qualitative information.
  • Involve and activate senior leadership more effectively in the strategic planning process.
  • Pinpoint departments, teams, or individuals that need to improve the quality of their performance.
  • Provide easier methods to benchmark performance and compare levels of service.

Convinced it’s worth the effort? Good. To help you get started, below are examples of quality measures in healthcare that can make a big difference for your organization’s strategy.

22 Commonly Used Quality Performance Measures In Healthcare

This list contains some of the most important quality performance measures in healthcare, organized by category. Click To Tweet

While our previous article on healthcare metrics gave you a broad overview of key performance measures (KPIs) you should track and report on, this list contains some of the most important quality performance measures in healthcare, organized by category:

Operations

  1. Number of Patients Served Per Month: Tracks the number of individuals receiving care each month. This helps a healthcare facility grasp the overall volume of services provided, which is a foundational metric for how to manage quality within the organization.
  2. Length of Stay: Shows how quickly medical staff are able to diagnose and prescribe treatment; also helps create standards regarding time allotments for different treatment types.
  3. Readmission Rates: Assesses quality of care by the number of patients re-entering the hospital or clinic for the same condition they were previously treated for and then discharged. This measure can also help pinpoint overlooked complications.
  4. Equipment Utilization Rate: Monitors the number of days equipment was actually available, compared to the days the equipment was expected to be available. Equipment issues often correlate with lower or impeded quality of care.
  5. Staff Overtime: Demonstrates the amount of time staff members work beyond their normal hours, which can indicate whether a facility has too many or too few staff resources. This is often tracked with related performance measures in healthcare organizations, such as the staff-to-patient ratio.
  6. Operating Room Utilization: Calculates the percentage of business hours daily in which the room is used. About 75–85% utilization is ideal, but some health systems are scheduling surgery past traditional business hours to enhance revenue.

Get a comprehensive list of 108 healthcare KPIs in this free library.

Finance

  1. Total Expenditures (All Sources): Accounts for the total amount of money the organization spends. Depending on the size of your hospital or clinic, this can be broken up by product and service, or shown as a total amount.
  2. Total Operating Margin: Measures a hospital’s profit, after removing costs. This indicates the effectiveness of a hospital’s pricing strategy and overall operations. It also shows how much funding is available to cover non-operating costs.
  3. Average Cost Per Discharge: Averages the cost incurred for a patient's entire stay, which can uncover areas of overspending. This measure can also be benchmarked against similar facilities to help assess performance.
  4. Bad Debt: Calculates the difference between the amount billed to a patient and the amount actually paid by the patient. This is also called uncompensated care and impacts a hospital’s overall revenue.
  5. Specialist Net Revenue: Calculates the profits directly attributable to specialists. Many healthcare facilities are choosing to co-opt specialist physicians as employees or independent contractors to benefit from referrals and keep patients in their system.
  6. Elective Surgery Revenue: Calculates the profits directly attributable to elective surgeries, one of the highest-revenue services in the industry. COVID-19 negatively impacted this number for most hospitals, who may need a new strategy to ramp up these services going forward.
  7. Nurse Practitioner Productivity And Quality Of Care: Definitions of productivity vary by setting and facility, but these measures are intended to assess the facility’s strategic utilization of nurse practitioners, who can evaluate and treat most minor illnesses at a lower cost than doctors.
  8. Average Insurance Claim Processing Time And Cost Per Claim: Demonstrates the efficiency of your insurance claims process. Staying on top of your performance in this area ensures faster payment—and at a reasonable cost to the patient.

Communications

  1. Inpatient/Outpatient Satisfaction With Physician: Communicates the level of satisfaction among patients who were admitted (or received care without being admitted) to the healthcare facility. This is a subset of the quality performance measurement that tracks overall patient satisfaction.
  2. Employee Turnover Rate: Shows the steadiness of the workforce. High turnover can affect the level of care and effectiveness of the facility.
  3. Employee Satisfaction: Gauges the satisfaction level of employees, which can impact turnover rates and therefore also affect the level of care.
  4. Percentage Of Electronic Health Records (EHR): Demonstrates an organization’s level of technological advancement. A low percentage of EHRs can translate to inconsistencies or disparities in quality of care, as well as indicate the facility isn’t compliant with federal mandates.

Care

  1. Patient Retention Rate: Shows how many patients return to the facility for another unrelated visit, which typically aligns with patient satisfaction.
  2. Quality Of Nursing Care: Assesses whether patients were satisfied with the level of care they received from nurses during their time at the facility. The purpose is to take a closer look at the performance of one category of staff.
  3. Mortality Rates: Tracks the observed number of patient deaths versus the expected number of deaths. This measure is linked to a facility’s effectiveness at managing preventable deaths.
  4. Rate of Complications: Indicates how many patients have complications related to the care they received at the facility. This can involve tracking quality measures in healthcare facilities such as unintentional consequences or side effects from procedures.

The Impact Of COVID-19 On Healthcare KPIs

Business objectives in every industry changed when COVID-19 hit, and healthcare is no exception. The pandemic required a new, delicate balancing act from hospitals: the need to maintain overall community health while simultaneously treating seriously ill patients. To meet these new objectives, hospitals were forced to pivot.

What changed, exactly? For one, many hospitals were forced to forego elective surgeries and preventative care to maintain sufficient capacity for COVID-19 patients, as well as to prevent the virus from spreading. Not only did this put hospitals in a difficult spot financially, but it also increased the potential for worsening outcomes for patients with delayed surgeries.

Another major change was the rise of telehealth. While many healthcare providers had been toying with the idea in previous years, few took action until they were forced to in 2020. Before the pandemic, Blue Cross Blue Shield received about 200 telehealth claims a day; in April and May 2020, that number spiked to 40,000.

Now is the perfect time for healthcare facilities to do a SWOT analysis—a strategic exercise that’s especially effective in times of uncertainty. SWOT gives you the opportunity to consider what you do know—your current strengths and weaknesses, as well as potential areas for growth—to help plot a course forward.

For hospitals, telehealth presents an opportunity. Telehealth has proven to be a welcome change for patients, thanks to the convenience factor. It’s also good for hospitals: One hospital member reported that its facility’s telehealth services saw a 10-fold increase in patient access to specialists while reaching 39% more ZIP codes in the state.

Additionally, healthcare facilities need to anticipate the long-term impact of delayed medical care. No one knows exactly what that might look like in the years ahead, but it’s imperative to chart a strategy that considers the end result.

New strategies require you to rethink your quality measures. In fact, one third of healthcare leaders have said they plan to alter what they measure and how often they measure it going forward due to the necessary changes in practice brought on by the pandemic.

To help adapt to the new environment, some new performance measures in healthcare might include:

  1. Number Of Telehealth Appointments: Demonstrates how your organization is keeping up and adapting to this new—and potentially significant—revenue source during and after the pandemic.
  2. Patient And Employee Safety: Keeping track of hospital-acquired COVID-19 infections, percentage of essential PPE with a 30-day supply, and other factors demonstrate your facility’s dedication to creating a safe and healthy space for patients and workers.
  3. Critical Care Capacity: As hospitals continue to struggle balancing COVID-19 patients with those in need of other treatments, the 7-day average percentage of available ICU and acute care beds is an indicator of capacity.
  4. Rate Of Weekly Change In COVID-19-positive Hospitalizations: This measure reflects the ongoing demand placed on a facility.

Want more examples of performance measures in healthcare?

There are many more measures you can track and report on that will give you a better idea of performance levels and the quality of care within your hospital. Check out our complete library of healthcare metrics—it’s free to download.

Just keep in mind that you can’t track everything. You’ll need to pick and choose which quality measures will best help your healthcare facility achieve its strategic objectives.

22 Commonly Used Quality Performance Measures In Healthcare