, Volume 27, Issue 4, pp 395-397
Date: 21 Jan 2012

The Double Edged Sword of Performance Measurement

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Among the high priority outcomes sought in reforming American health care are greater provider accountability, better processes of care and improved clinical outcomes, more satisfying care experiences for both patients and caregivers, and greater operational efficiency. Performance measurement is an essential tool for implementing strategies aimed at achieving these goals.

In this issue of the Journal, Powell and colleagues describe a number of unintended consequences of implementing performance measurement in the Department of Veterans Affairs (VA) Health Care System,1 an early adopter of system-wide performance management.25 While there are significant limitations in generalizing the findings of this retrospective qualitative study, it is an important contribution to the growing body of evidence documenting the complexities of health care performance measurement and a poignant reminder that performance measurement is a tool that cuts both ways.

Powell et al, report the findings of 59 ...