Establishing national goals for quality improvement.
BACKGROUND
For a number of reasons, it has been difficult to garner public interest in the need to improve the quality of care delivered nationally. One possible reason for this is that the concept of quality has different meanings for different stakeholders. To make the problems of suboptimal quality more concrete and potential solutions more compelling, the Strategic Framework Board (SFB) recommended developing a set of national goals for quality improvement.


OBJECTIVE
To describe the criteria by which national goals should be selected, illustrate the analytic methods that should be used to support the development of such goals, and describe and illustrate a process by which national goals could be formulated.


METHODS
Targeted review of literature and discussions among members of the SFB.


RESULTS
National goals have played a key role in making progress under the Healthy People 2000 and Health People 2010 initiatives. The recommended process will involve assembling key evidence as well as engaging in a consensus process.


CONCLUSIONS
Developing a set of national goals for quality improvement is a key activity for a national quality measurement and reporting system to undertake. The steps outlined here represent a feasible and productive method for accomplishing this objective.
McGlynn
Elizabeth A
EA
RAND Health, Santa Monica, California 90401, USA. mcglynn@rand.org.
Cassel
Christine K
CK
Leatherman
Sheila T
ST
DeCristofaro
Alison
A
Smits
Helen L
HL
D000328:Adult; D000368:Aged; D002648:Child; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D040361:Healthy People Programs; D006331:Heart Diseases / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D009017:Morbidity; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D015995:Prevalence; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care / Q000592:standards*; D011788:Quality of Life; D006113:United Kingdom; D014481:United States; D016270:United States Agency for Healthcare Research and Quality; D014944:World Health Organization