Types of Measures | Quality 101 | Quality & Innovation | SHM | Society of Hospital Medicine

Use a balanced set of measures for all improvement efforts: outcomes measures, process measures, and balancing measures.

Outcome Measures

How does the system impact the values of patients, their health and wellbeing? What are impacts on other stakeholders such as payers, employees, or the community?

  • For diabetes: Average hemoglobin A1c level for population of patients with diabetes
  • For access: Number of days to third next available appointment
  • For critical care: Intensive Care Unit (ICU) percent unadjusted mortality
  • For medication systems: Adverse drug events per 1,000 doses

Process Measures

Are the parts/steps in the system performing as planned? Are you on track in your efforts to improve the system?

  • For diabetes: Percentage of patients whose hemoglobin A1c level was measured twice in the past year
  • For access: Average daily clinician hours available for appointments
  • For critical care: Percent of patients with intentional rounding completed on schedule.

Balancing Measures


Looking at a system from different directions/dimensions

Are changes designed to improve one part of the system causing new problems in other parts of the system?

  • For reducing time patients spend on a ventilator after surgery: Make sure reintubation rates are not increasing.
  • For reducing patients' length of stay in the hospital: Make sure readmission rates are not increasing.

From the Institute of Healthcare Improvement’s “Science of Improvement: Establishing Measures”.

If you need additional support in leading a quality improvement effort, SHM’s signature programs can guide your team through each phase and provide individual mentoring in areas such as care transitions (Project BOOST®), Glycemic Control (GC), Medication Reconciliation (MARQUIS), Atrial Fibrillation (AFIB) and Venous Thromboembolism (VTE). We also provide resources by clinical topic to help you find exactly what you need.

No matter where you are in the spectrum, SHM can assist you in your efforts. SHM encourages you to join the QI community and view the calendar for up to date information on key events and discussions around the quality and innovation movement.

Questions or Comments, please email thecenter@hospitalmedicine.org.

s or Comments, please email thecenter@hospitalmedicine.org.