Measuring "goodness" in individuals and healthcare systems

doi:10.1136/bmj.325.7366.704

BMJ 2002;325:704-707 ( 28 September )

Education and debate

Measuring "goodness" in individuals and healthcare systems

Mike Pringle, professor ^a, Tim Wilson, director ^b, Richard Grol, professor ^c.

^a Division of General Practice, University of Nottingham, Nottingham NG7 2RD, ^b Quality Unit, Royal College of General Practitioners, London SW7 1PU, ^c Director's Centre for Quality of Care Research (WOK), Nijmegen University, Netherlands PO Box 9101, 6500 HB Nijmegen, Netherlands

Correspondence to: M Pringle
mike.pringle@nottingham.ac.uk

The first 150 words of the full text of this article appear below.

All agree that we need to measure the quality of health care, including the care given by individual doctors. Measuring "goodness"requires accurate data used appropriately, and it must be donewithout demoralising and demotivating staff. Do current measuresfulfil these requirements, and if not, what measures should beused?

In the recent Reith lectures (broadcast annually by BBC radio on issues of contemporary interest), Onora O'Neill exploredthe new age of accountability. She concluded that increasing relianceon measurement reduced trust in health (and other public) servicesand that professionals and public servants should be"free to servethe public.'¹ This will ring true withmany.

However, patients, funders, commissioners, provider organisations, and health professionals legitimately want to know justhow "good" are individual doctors, teams, and healthcare providingorganisations. The traditionally qualitative, anecdotal approach,supplemented by trust, is being increasingly replaced by dataon effectiveness, safety, acceptability, andefficiency.

. . . [Full text of this article]

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