ArticlePloS one
An evidence-based, structured, expert approach to selecting essential indicators of primary care quality.
Article in PloS one. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Mapping Quality Indicators in Primary Health Care: A Scoping Review of Contemporary Approaches and Persistent Measurement Gaps.Healthcare (Basel, Switzerland) · 2026Review
- Rural Practice Made Attractive: A Scoping Review of Rural Primary Care Physician Recruitment and Retention Incentives.Journal of general internal medicine · 2026Article
- Can medical assistants help improve family medicine practices in Croatia?Croatian medical journal · 2026Article
- Impact of Primary Care Team Configuration on Access and Quality of Care.Journal of general internal medicine · 2025Observational
- Enhancing primary care quality improvement through national data collection and validation: the primary care quality initiative in Sweden.Scandinavian journal of primary health care · 2025Article
- Churning the tides of care: when nurse turnover makes waves in patient access to primary care.BMC nursing · 2024Article
- Regular measurement is essential but insufficient to improve quality of healthcare.BMJ (Clinical research ed.) · 2023Article
- What can we learn from COVID-19?: examining the resilience of primary care teams.Frontiers in psychology · 2023Article
- Care delivery team composition effect on hospitalization risk in African Americans with congestive heart failure.PloS one · 2023Article
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Authors and funding
13 authors.
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Abstract
backgroundThe purpose of this article is to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and (when appropriate) generate new measures of health care quality, using primary care as a case example. Primary health care is central to the health care system and health of the American public; thus, ensuring high quality is essential. Due to its complexity, ensuring high-quality primary care requires measurement frameworks that can assess the quality of the infrastructure, workforce configurations, and processes available. This paper describes the use of the Productivity Measurement and Enhancement System (ProMES) to compile a targeted set of such measures, prioritized according to their contribution and value to primary care.
methodsWe adapted ProMES to select and rank existing primary care measures according to value to the primary care clinic. Nine subject matter experts (SMEs) consisting of clinicians, hospital leaders and national policymakers participated in facilitated expert elicitation sessions to identify objectives of performance, corresponding measures, and priority rankings.
resultsThe SMEs identified three fundamental objectives: access, patient-health care team partnerships, and technical quality. The SMEs also selected sixteen performance indicators from the 44 pre-vetted, currently existing measures from three different data sources for primary care. One indicator, Team 2-Day Post Discharge Contact Ratio, was selected as an indicator of both team partnerships and technical quality. Indicators were prioritized according to value using the contingency functions developed by the SMEs.
conclusionOur article provides an actionable guide to applying ProMES, which can be adapted to the needs of various industries, including measure selection and modification from existing data sources, and proposing new measures. Future work should address both logistical considerations (e.g., data capture, common data/programming language) and lingering measurement challenges, such as operationalizating measures to be meaningful and interpretable across health care settings.
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