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Clinical Practice Guidelines: Directions for a New Program (1990)

Chapter: Professional and Technical Usage

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Suggested Citation:"Professional and Technical Usage." Institute of Medicine. 1990. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press. doi: 10.17226/1626.
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Page 48

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DEFINITIONS OF KEY TERMS 48 might also be premature, given that the Department of Health and Human Services and Congress are considering a variety of policy and strategy issues related to broad questions of quality assurance and assessment. Decisions on these issues presumably should influence the Forum's work. PERFORMANCE MEASURES This concept is the most unfamiliar of the four terms in OBRA 89. It is seldom used in the professional literature and has a variety of dictionary definitions. Common Usage: The Dictionary Random House offers for performance "the manner in which or the efficiency with which something reacts or fulfills its intended purpose." The OED provides two relevant definitions for performance: "1. the carrying out of a demand, duty, purpose, promise, etc.; 2. the accomplishment, execution, . . .of anything ordered or undertaken." The OED gives many different definitions for measure. As a verb, these include "1. to form an estimate of (now especially to weigh or gauge the character or ability of something [e.g., a person]), with a view to what to expect [from that person]; 2. to ascertain or determine the spatial magnitude or quantity of [something] by application or comparison to some known or fixed unit; 3. to estimate the amount, duration, value, etc., of an immaterial thing [perhaps, performance] by comparison with some standard; 4. to judge or estimate the greatness or value of (a person, a quality) by a certain standard or rule; and to appraise by comparison with something else." As a noun, the definitions of measure include "1. an instrument for measuring [e.g., a vessel, graduated rod, line, tape, etc. . . .]; and 2. a method of measuring, especially a system of standard denomination of units of length [etc.]." Professional and Technical Usage The term performance measure has been used by the Joint Commission on Accreditation of Healthcare Organizations, but the commission intends, in the future, to substitute the term indicator (R. Marder, project manager, Indicator Development, personal communication, April 24, 1990). Committee staff found virtually no discussion of performance measures in the literature they reviewed. Joint Commission (1989b:4-5): "Performance measures provide data and information that serve as the basis for determining whether expectations are met." A clinical indicator is a "generic term. . .intended to emphasize

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