Clinical quality initiatives: The search for meaningful- and accurate- measures

At times, it seems as though every hospital, hospital association, philanthropic foundation and major corporation in the country is involved in the quality movement in health care. This cover package looks at a major component of that movement-the broad efforts to develop clinical quality measurement tools-from four different perspectives. In our first story, we provide an update on the Maryland Quality Indicator Project and its ongoing use as a role model for many of the newer clinical indicator projects. Next, we look at the JCAHO and its Agenda for Change project, as well as other large-scale quality measurement programs under way in the private sector that are attempting to determine what indicators are meaningful to use. Then, we examine the growing role of corporate payers in pushing hospital-comparison and other assessment programs forward. Finally, we look at the federal government's role in developing practice guidelines and outcomes research.