of a measure usually begins with the numerator, denominator, exclusions and measure logic. In general, electronic claims data are the least resource-intensive method available to collect targeted quality measure components.

Pitfalls to Avoid When Developing Measures
The process for developing quality measures can be time consuming and resource-intensive. To maximize the likelihood that any given measure will be predictive of quality and universally accepted, certain practices should be avoided. These include avoiding the use of medications as a marker for diagnosis and measures that require multiple steps for analysis or incorporate complex algorithms.

Selecting the right set of measures for your organization
The standards or measures used by an organization will be determined by the specific quality goals of the organization. Managed care organizations can select from existing measures and standards, including those required for voluntary, third-party accreditation from URAC, NCQA and others. URAC accreditation, for example, requires compliance with a comprehensive set of standards addressing core organizational quality, program-specific services and operations. NCQA accreditation requires performance data on a variety of clinical and other quality measures. Organizations also may select from existing measures developed and required by government agencies, prospective clients and within the organization itself.

Developing a Detailed Task Plan and Identifying Hurdles and Challenges
Implementing quality measures requires an organizational-wide commitment. Consider the proposed task list to identify key hurdles/challenges:

Task 1: Kick off meeting with assigned facilitator and staff.

Task 2: Identify goals and objectives.

Task 3: Measurement strategy design.

Task 4: Review quality and usefulness of individual measures.

Task 5: Validate final list of measures and the availability of supporting data.

Task 6: Build measures and test against sample test data to ensure accuracy and appropriateness.

Task 7: Stress test measurement performance execution time to maximize performance and ensure measurement completion is obtainable in large data scenario.

Gaining Administrative Support/ Building a Business Case for Quality Improvement
For a quality improvement approach to be most effective, it’s important that it be a recognized and prioritized initiative within the organization. Therefore it is important to seek out and gain administrative support for proposed quality improvement initiatives before they begin.

Goal Setting
Goals and objectives need to be identified and clearly stated when implementing a program that measures quality. Goals need to state objectives; what needs to be done, why these goals are important, who is involved, what needs to be ultimately accomplished and how it will be accomplished. A step by step plan to reach these goals must have specific time frames with deadlines and must be realistic. There should be ongoing evaluation of the goals and the process. Endpoints must be concise and there needs to have an established criteria on how to measure the progress of achieving these goals so that change can be seen. Program interventions should measure the program’s success, areas for improvement and measure what else needs to be completed in order to achieve the goal.
     Members of AMCP’s Quality Task Force through April 2010: Michael Tocco (chair), Janice Anderson, Carey Cotterell, Sue Cooper, Nancy England, Ed Lennard, Kim McDonough and Terri Moore.
    To access “A Guide Toward Quality,” visit www.amcp.org and click on the Professional Practice tab followed by AMCP Publications.