ArticleJournal of general internal medicine2016
A Novel Method for Assessing Task Complexity in Outpatient Clinical-Performance Measures.
Article in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pay-for-Performance and Veteran Care in the VHA and the Community: a Systematic Review.Journal of general internal medicine · 2018Pooled it
- Using a dark logic model to explore adverse effects in audit and feedback: a qualitative study of gaming in colonoscopy.BMJ quality & safety · 2022Trial
- Study protocol: maintaining preventive care during public health emergencies through effective coordination.Implementation science communications · 2023Article
- What can we learn from COVID-19?: examining the resilience of primary care teams.Frontiers in psychology · 2023Article
- The Next Generation of Clinical Performance Measures.Journal of general internal medicine · 2016Article
- Linking clinician interaction and coordination to clinical performance in Patient-Aligned Care Teams.Implementation science : IS · 2016Article
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3 authors.
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Abstract
backgroundClinical-performance measurement has helped improve the quality of health-care; yet success in attaining high levels of quality across multiple domains simultaneously still varies considerably. Although many sources of variability in care quality have been studied, the difficulty required to complete the clinical work itself has received little attention.
objectiveWe present a task-based methodology for evaluating the difficulty of clinical-performance measures (CPMs) by assessing the complexity of their component requisite tasks.
designUsing Functional Job Analysis (FJA), subject-matter experts (SMEs) generated task lists for 17 CPMs; task lists were rated on ten dimensions of complexity, and then aggregated into difficulty composites.
participantsEleven outpatient work SMEs; 133 VA Medical Centers nationwide. MAIN MEASURES: Clinical Performance: 17 outpatient CPMs (2000-2008) at 133 VA Medical Centers nationwide. Measure Difficulty: for each CPM, the number of component requisite tasks and the average rating across ten FJA complexity scales for the set of tasks comprising the measure. KEY
resultsMeasures varied considerably in the number of component tasks (M = 10.56, SD = 6.25, min = 5, max = 25). Measures of chronic care following acute myocardial infarction exhibited significantly higher measure difficulty ratings compared to diabetes or screening measures, but not to immunization measures ([Formula: see text] = 0.45, -0.04, -0.05, and -0.06 respectively; F (3, 186) = 3.57, p = 0.015). Measure difficulty ratings were not significantly correlated with the number of component tasks (r = -0.30, p = 0.23).
conclusionsEvaluating the difficulty of achieving recommended CPM performance levels requires more than simply counting the tasks involved; using FJA to assess the complexity of CPMs' component tasks presents an alternate means of assessing the difficulty of primary-care CPMs and accounting for performance variation among measures and performers. This in turn could be used in designing performance reward programs, or to match workflow to clinician time and effort.
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