Quality Metrics in Healthcare: Top Measures for Improving Care Quality

The lack of quality metrics in healthcare can bring down even the most established organization.

A large hospital may operate without metrics to monitor care processes, outcomes, or patient safety because “that’s the way things have always been done.” But gradually, cracks begin to show. Medical errors go unnoticed, misdiagnoses increase, infection rates rise, and patient outcomes worsen.

Soon, a patient sues the hospital for malpractice, and their lawyer uses the lack of documented quality metrics to prove systemic negligence. The hospital loses the lawsuit and pays a multi-million-dollar settlement.

Does your healthcare organization have a way to track quality metrics, or do things operate on gut instinct and informal communication? Tracking quality metrics in healthcare ensures patient safety, improves clinical outcomes, and drives continuous improvement across the entire care delivery system.

What are Quality Metrics in Healthcare?

Quality metrics (quality measures or indicators) are tools that help healthcare organizations track and evaluate how well they deliver care to enhance performance. They focus on aspects such as medical procedures, patient experiences, clinical outcomes, and how organizational systems work together to deliver high-quality care. The metrics support key healthcare goals to ensure institutions provide care that is safe, timely, efficient, effective, patient-centered, and fair.

Why are Quality Metrics Important in Healthcare?

Quality metrics offer a deeper insight into patient safety and clinical performance, enabling institutions to identify areas for improvement. Organizations that utilize healthcare quality measures enhance patient care by monitoring and refining healthcare processes and outcomes. The metrics provide quantifiable data that organizations can use to demonstrate adherence to laws and regulations. They also make healthcare providers more accountable for the quality of care they deliver. 

Quality metrics enhance decision-making in clinical and administrative functions by providing data-driven insights. Organizations can identify areas for improvement and continually enhance the quality and efficiency of their healthcare services.

What is a Healthcare Quality Management Dashboard?

Healthcare organizations generate vast amounts of data every day, and managing the data can be difficult if it’s stored in different systems. A quality management dashboard, such as PRIME® by Atlas Systems, centralizes data, enabling organizations to monitor, analyze, and improve patient care and operational performance. It makes it easier to see and understand important healthcare data by focusing on key areas like:

• Structures: Information on facilities and staff, such as the physician-to-patient ratio.
• Care processes: How well medical care is delivered to patients. For example, the percentage of patients getting screened.
• Outcomes: The results of medical interventions or treatments, such as symptom improvement or disease progression.

A healthcare quality management dashboard also highlights many important quality metrics, such as:

• Patient safety
• Patient experience
• Medical errors
• Patient complaints and satisfaction ratings
• Clinical outcomes
• Compliance with standards
• Efficiency of Care
• Operational performance

A healthcare quality management dashboard helps administrators and nurse leaders compare their team’s performance with that of other teams within the same institution or another one. They see what’s working and what needs improvement. They can use visual charts and graphs to identify patterns, problems in care, and performance differences. Additionally, the dashboard enables decision-makers to track whether improvement initiatives are actually effective.

What Metrics Should you Include on a Healthcare Quality Management Dashboard?

While it’s important to choose quality metrics based on your company’s needs and payers’ reporting requirements, you shouldn’t overlook the requirements of accrediting bodies or CMS’s quality programs. In the past, CMS has used these five quality factors to rate thousands of hospitals on a scale of one to five stars.

1. Safety

Safety metrics evaluate the ability of healthcare professionals to deliver high-quality patient care without triggering adverse reactions. They are related to medical incidents and include unintentional consequences or side effects of hospital procedures, such as postoperative respiratory failure, hemorrhages, pulmonary embolisms, and other reactions or infections. 

The most common patient safety measures are: 

• Healthcare-acquired infections (HAIs): These occur while patients are receiving care and include central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, and ventilator-associated events 
• Medication errors: These are mistakes in the prescribing, dispensing, or administration of medications, such as giving the wrong drug or dose, or missing medications
• Pressure injuries (bedsores): How often patients develop pressure sores during care, which shows poor mobility management
• Patient falls: How often patients fall during their hospital stay; tracks falls that result in injury
• Adverse events: Any harm or injury caused by medical care, such as surgical complications or allergic reactions

You can quantify this measure by tracking the number of harm events per 1,000 patient days, per 1,000 doses given, or per 1,000 patients treated. Be sure to align these quality metrics with regulatory bodies and industry standards.

2. Patient experience

These healthcare quality measures evaluate patients’ perceptions of the care they receive. They demonstrate the level of patient involvement in decision-making processes and the effectiveness of communication between patients and healthcare providers. Healthcare organizations can evaluate patient experiences by administering patient satisfaction surveys and tracking complaints.

One commonly used survey is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. It measures various aspects of patient satisfaction, ranging from the cleanliness of the healthcare facility to the quality of care. The ratings provide healthcare providers with vital information on how to improve patient care and services.

3. Timely and effective care

Timely and effective care has a direct impact on patient outcomes, safety, and satisfaction. When care is delivered quickly and without unnecessary delays, health outcomes improve, patient satisfaction grows, and hospital efficiency goes up. 

These care metrics include waiting times from arrival at the emergency department (ED) until diagnostic evaluation and the average length of hospital stays. Increased waiting times in the emergency department are often associated with higher inpatient mortality rates, longer hospital stays, and increased costs for admitted patients.  

Effective care metrics assess compliance with best practice care guidelines and clinical outcomes. Clinicians who follow established care guidelines tend to improve clinical outcomes. It’s also important to monitor treatment outcomes and notify clinicians when care guidelines require review. 

4. Readmission

Patient readmission indicators measure the effectiveness of care management during and after a hospital stay. High readmission rates often indicate gaps in care, inadequate discharge planning, or a lack of follow-up by physicians, which can result in poorer health outcomes and higher costs. Lower readmission rates indicate higher quality of care. The average readmission rate in 2024 was 14.56%, and the average readmission cost was $16,300 per patient.

Readmission metrics include condition-specific readmission rates, 30-day all-cause readmission rates, and readmission rates after surgical procedures. Most metrics measure the percentage of patients who are readmitted within 30 days of discharge. Medical institutions must determine the optimal length of stay to prevent readmission and boost patient and financial health. 

Hospital readmissions cost Medicare $26 billion annually, and the agency penalizes institutions by withholding full reimbursement payments. High readmission rates can lead to decreased hospital revenue.

5. Mortality

Mortality metrics clearly demonstrate the effectiveness and safety of healthcare services. Care providers must track and analyze these metrics to determine whether patients are surviving their conditions and procedures. If not, they should check where care might be falling short.

The patient mortality metric measures the percentage of patients who die before being discharged from the hospital. Mortality rate measures how effectively healthcare providers manage a patient’s recovery after surgery or medical treatment.

Use PRIME® by Atlas Systems to Track Quality Metrics in Healthcare

Quality metrics provide healthcare organizations with deeper insight into areas of patient safety or clinical performance that may need improvement. Medical providers who regularly measure the above metrics can improve care standards and reduce the risks associated with poor clinical outcomes.

Take control of healthcare quality management with PRIME® by Atlas Systems. Our intuitive platform helps you track, analyze, and improve your quality metrics with ease. You gain real-time visibility into key performance indicators such as patient safety, timely care, readmissions, and mortality rates. 

Automated data collection, customizable dashboards, benchmarking tools, and other features empower your administrators and nurse leaders to make informed decisions. 

Track, measure, and improve healthcare outcomes with PRIME® today.

FAQs

1. How is KPI different from quality metrics?

KPIs (Key Performance Indicators) are broader performance measures that track progress toward internal goals, while quality metrics focus on the quality of care provided. KPI examples include financial performance and staff turnover rate, whereas quality metrics include patient safety and the effectiveness of care.

2. What are the types of healthcare quality measures?

The three main types of healthcare quality measures used by medical organizations are structural measures (which assess the resources and systems in place), process measures (which evaluate if specific care steps are done correctly), and outcome measures (which focus on the results of healthcare).

3. How often should quality metrics be measured?

At least monthly or quarterly, depending on the metric and its importance to your organization. Critical metrics, such as patient safety events or infection rates, should be tracked on a weekly or daily basis to ensure problems are identified and addressed promptly. Balancing timely monitoring with data collection ensures healthcare providers act fast without being overwhelmed.

4. Can quality metrics be used for benchmarking?

Yes, quality metrics can be used for benchmarking in healthcare. Benchmarking involves comparing your organization’s performance against other healthcare facilities, industry standards, and national averages to identify areas of strength and opportunities for improvement. By using quality metrics, you can identify performance gaps and establish targeted improvement goals.

5. What is the difference between quality assurance and quality metrics?

Quality metrics are measurable indicators that demonstrate how healthcare services meet specific standards. Quality assurance, on the other hand, is a comprehensive process that ensures healthcare services consistently meet those standards through continuous monitoring, assessment, and improvement of healthcare processes.