title: Measuring quality of care: considering measurement frameworks and needs assessment to guide quality indicator development.
abstract: OBJECTIVE
  In this article, we describe one approach for evaluating the value of developing quality indicators (QIs).
  
  
  METHODS
  We focus on describing how to develop a conceptual measurement framework and how to evaluate the need to develop QIs. A recent process to develop QIs for injury care is used for illustration.
  
  
  RESULTS
  Key steps to perform before developing QIs include creating a conceptual measurement framework, determining stakeholder perspectives, and performing a QI needs assessment. QI development is likely to be most beneficial for medical problems for which quality measures have not been previously developed or are inadequate and that have a large burden of illness to justify quality measurement and improvement efforts, are characterized by variable or substandard care such that opportunities for improvement exist, and have evidence that improving quality of care will improve patient health.
  
  
  CONCLUSIONS
  By developing a conceptual measurement framework and performing a QI needs assessment, developers and users of QIs can target their efforts.
authors.affiliation: Department of Critical Care Medicine, Institute for Public Health, University of Calgary, Teaching Research & Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6; Department of Medicine, Institute for Public Health, University of Calgary, Teaching Research & Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6; Department of Community Health Sciences, Institute for Public Health, University of Calgary, Teaching Research & Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6. Electronic address: tstelfox@ucalgary.ca.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
mesh_terms: D006801:Humans; D020380:Needs Assessment; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000592:standards
keywords: Health care; Models; Needs assessment; Quality indicators; Quality of health care; Survey; Systematic review; Theoretical