high-level information and links to resources that can help AMCP members initiate quality measurement programs within their organizations.
     The guide is intended for those members not already familiar with implementing quality measures. Topics covered include:

• What is a measure?
  
• How do you measure?
  
• Pitfalls to avoid when developing measures
  
• Selecting the right set of measures for your
  organization
  
• Developing a detailed task plan and identifying
  hurdles and challenges
  
• Gaining administrative support by building a
  business case for quality improvement
  
• Goal setting

The guide also provides a glossary of terms as well as web links and publication references for readers to drill down to multiple layers of authoritative detail.
     The guide comes amid growing expectations around quality improvement. Increasingly, managed care organizations must implement and report results of quality initiatives not only to third-party payers, government agencies, and organizations that are studying quality, but also directly to the public.
     In addition, health care organizations are under pressure to lower costs. Improving quality and lowering costs and are frequently linked, both positively and negatively. “Throwing money at the problem” as a solution to a quality issue should not be the knee-jerk response. But lasting change often  

requires an initial investment of time, money or both. The ultimate goal of quality improvement is to provide better structures and processes of care, which may ultimately result in improved health care outcomes and lowering the cost of care (e.g. improving operational efficiency, avoiding error, reducing rework, educating for appropriate medications, and improving outcomes by enhancing compliance and safety).
     An understanding of quality improvement techniques can help improve the chances that the desired outcome(s) are achieved. It was with this in mind that AMCP’s Quality Task Force, in place from 2007-April 2010, developed this guide. The following are some of the concepts explored in the document.

What is a “Measure”?
It is important to understand the difference between “indicators” and “measures,” and their relationship to “goals.”

• A “goal” is a broad, overarching, general intention— i.e., “Improve the accuracy of our outpatient prescription dispensing.”
• A quality “indicator” refers to an attribute of care or service that is conceptual in nature—i.e., an indicator of the accuracy of outpatient prescription dispensing could be, “Directions for use on the Rx label are accurate.”
• A “measure” is used to quantify the performance relevant to an individual indicator. A measure for accurate directions for use on the Rx label would be—“The percent of Rx labels dispensed that contain the correct directions for use,” or “The number of incorrect directions for use on a sample of 10,000 Rx container labels.” 

How do you Measure?
Once the technical specifications for the finalized quality measure have been detailed and tested, pertinent data can then be collected, analyzed and reported in a consistent, reliable and effective manner. Most quality measures are expressed as a rate. The basic construct