title: A research agenda to advance quality measurement and improvement.
abstract: BACKGROUND
  In developing a conceptual framework for the design of a national quality measurement and reporting system (NQMRS), the Strategic Framework Board (SFB) recommends that such a system be built on a strong evidence base.
  
  
  OBJECTIVE
  To identify critical gaps in the evidence needed for a fully functional NQMRS and to recommend a starting point for the development of a research agenda.
  
  
  METHODS
  Selective review of literature in quality of care measurement and reporting and identification of strategic issues that must be addressed.
  
  
  RESULTS
  There is some limited evidence that measurement and reporting can improve quality. Substantial advances have been made in the science of measurement and reporting but important gaps remain, specifically in (1) measurement methods and tools, (2) uses of quality performance data, (3) organizational and cultural factors, (4) information and informatics, and (5) impact evaluation/research.
  
  
  CONCLUSIONS
  To achieve a sustainable research agenda, three strategic issues will have to be addressed: (1) the policy rationale for the research agenda, (2) adequate levels of public-sector funding, and (3) sustainability in a rapidly changing environment.
authors.affiliation: School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA. sheila_t_leatherman@uhc.com
authors.forename: Sheila T
authors.initials: ST
authors.lastname: Leatherman
authors.forename: Judith H
authors.initials: JH
authors.lastname: Hibbard
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: McGlynn
mesh_terms: D035843:Biomedical Research / Q000191:economics; D006801:Humans; D015279:Organizational Culture; D009937:Organizational Objectives; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000592:standards*; D012109:Research Support as Topic