Using Data for Quality Assessment and Improvement

  • Galen L. Barbour
Part of the Computers in Health Care book series (HI)


For more than a quarter century, clinical data collection and analysis have been carried out in the name of quality; more often than not the analysis involved the retrospective evaluation of circumstances with outcomes that were less than anticipated. In most cases, the data were the basis of a “search for the guilty” and provided the basis for punitive actions taken to remove “bad apples” (Berwick, 1989). Physician activities were generally a focal point for these searches, and individual practitioners naturally developed a defensive attitude toward the entire data collection and analysis process. These pessimistic attitudes about the value of the quality process generally include a rather negative disposition toward the entire issue of measurement. There is a concept, instilled in us from early childhood, that measurement is always followed by some type of judgement like grades and report cards. Most of us feel we fall short, in one way or another, in some kind of measurement. Because we are reluctant to be judged inadequate, a reasonable defense is to avoid being measured. The human desire to avoid measurement has been amplified, for many physicians, by the punitive use of measurement and data obtained through the “quality process. ”


Veteran Affair Local Facility Veteran Health Administration Quality Health Care Patient Feedback 
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Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Galen L. Barbour

There are no affiliations available

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