John Norcini.
Medical Education
September 2005, Vol. 39, Issue #9, pg. 880-889.
Review by: Linda Heun, Ph.D. <lheun@aacom.org>
The author notes the increasing trend toward quality improvement and accountability in health care and the resulting need for more credible assessment measures of health care practitioners. He describes the basis of the assessment as patient outcomes, process of care and volume; the sources of information as clinical practice records, administrative databases, case logs and observations; and threats to validity and reliability as patient mix, patient complexity, attribution of impact in a multidisciplinary team approach to medicine, and number of patients.
Until new approaches are developed, he recommends that outcome-based process measures are preferable to patient outcomes because they are more directly in the control of doctors.
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