title: Using patient care quality measures to assess educational outcomes.
abstract: OBJECTIVE
  To report the results of a project designed to develop and implement a prototype methodology for identifying candidate patient care quality measures for potential use in assessing the outcomes and effectiveness of graduate medical education in emergency medicine.
  
  
  METHODS
  A workgroup composed of experts in emergency medicine residency education and patient care quality measurement was convened. Workgroup members performed a modified Delphi process that included iterative review of potential measures; individual expert rating of the measures on four dimensions, including measures quality of care and educational effectiveness; development of consensus on measures to be retained; external stakeholder rating of measures followed by a final workgroup review; and a post hoc stratification of measures. The workgroup completed a structured exercise to examine the linkage of patient care process and outcome measures to educational effectiveness.
  
  
  RESULTS
  The workgroup selected 62 measures for inclusion in its final set, including 43 measures for 21 clinical conditions, eight medication measures, seven measures for procedures, and four measures for department efficiency. Twenty-six measures met the more stringent criteria applied post hoc to further stratify and prioritize measures for development. Nineteen of these measures received high ratings from 75% of the workgroup and external stakeholder raters on importance for care in the ED, measures quality of care, and measures educational effectiveness; the majority of the raters considered these indicators feasible to measure. The workgroup utilized a simple framework for exploring the relationship of residency program educational activities, competencies from the six Accreditation Council for Graduate Medical Education general competency domains, patient care quality measures, and external factors that could intervene to affect care quality.
  
  
  CONCLUSIONS
  Numerous patient care quality measures have potential for use in assessing the educational effectiveness and performance of graduate medical education programs in emergency medicine. The measures identified in this report can be used as a starter set for further development, implementation, and study. Implementation of the measures, especially for high-stakes use, will require resolution of significant measurement issues.
authors: Department of Research and Education, Accreditation Council for Graduate Medical Education, Chicago, IL, USA. srs@acgme.org
authors: Susan R
authors: SR
authors: Swing
authors: Sandra
authors: S
authors: Schneider
authors: Ken
authors: K
authors: Bizovi
authors: Dane
authors: D
authors: Chapman
authors: Louis G
authors: LG
authors: Graff
authors: Cherri
authors: C
authors: Hobgood
authors: Thomas
authors: T
authors: Lukens
authors: Martha J
authors: MJ
authors: Radford
authors: Arthur
authors: A
authors: Sanders
authors: Rebecca
authors: R
authors: Smith-Coggins
authors: Linda
authors: L
authors: Spillane
authors: Laura
authors: L
authors: Hruska
authors: Robert L
authors: RL
authors: Wears
mesh_terms: D003697:Delphi Technique; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D004638:Emergency Treatment / Q000592:standards*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011787:Quality of Health Care