Care Consistency With Documented Care Preferences: Methodologic Considerations for Implementing the "Measuring What Matters" Quality Indicator.
A basic tenet of palliative care is discerning patient treatment preferences and then honoring these preferences, reflected by the inclusion of "Care Consistency With Documented Care Preferences" as one of 10 "Measuring What Matters quality" indicators. Measuring What Matters indicators are intended to serve as a foundation for quality measurement in health care settings. However, there are a number of logistic and practical issues to be considered in the application of this quality indicator to clinical practice. In this brief methodologic report, we describe how care consistency with documented care preferences has been measured in research on patients near the end of life. Furthermore, we outline methodologic challenges in using this indicator in both research and practice, such as documentation, specificity and relevance, preference stability, and measuring nonevents. Recommendations to strengthen the accuracy of measurement of this important quality marker in health care settings include consistent recording of preferences in the medical record, considerations for selection of treatment preferences for tracking, establishing a protocol for review of preferences, and adoption of a consistent measurement approach.
Indiana University Center for Aging Research, Indianapolis, Indiana, USA; Regenstrief Institute, Inc., Indianapolis, Indiana, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; RESPECT Signature Center, Indiana University Purdue University, Indianapolis, Indiana, USA. Electronic address: kunroe@iu.edu.
Kathleen T
KT
Unroe
Indiana University Center for Aging Research, Indianapolis, Indiana, USA; Regenstrief Institute, Inc., Indianapolis, Indiana, USA; Indiana University School of Nursing, Indianapolis, Indiana, USA; RESPECT Signature Center, Indiana University Purdue University, Indianapolis, Indiana, USA; Fairbanks Center for Medical Ethics, Indiana University Health, Indianapolis, Indiana, USA.
Susan E
SE
Hickman
Indiana University Center for Aging Research, Indianapolis, Indiana, USA; Regenstrief Institute, Inc., Indianapolis, Indiana, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; RESPECT Signature Center, Indiana University Purdue University, Indianapolis, Indiana, USA; Fairbanks Center for Medical Ethics, Indiana University Health, Indianapolis, Indiana, USA.
Alexia M
AM
Torke
D006801:Humans; D010166:Palliative Care / Q000379:methods*; D057240:Patient Preference; D019984:Quality Indicators, Health Care; D013727:Terminal Care / Q000379:methods
Measuring What Matters; Quality; measurement; treatment preferences
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