Performance Metrics as Drivers of Quality: Getting to Second Gear
For simplicity's sake, the history of U.S. health care performance improvement can be divided into the eras before and after the 1999 publication of To Err is Human by the Institute of Medicine1. Before publication of that report, the conventional wisdom was that the quality of health care was generally excellent, and, in any case, impossible to measure. Guidelines had been developed for some issues, but the preservation of physicians' autonomy to do what they judged best for patients was often invoked as the first principle of high quality health care.
- Received February 4, 2015.
- Accepted February 5, 2015.