Some interesting quality improvement resources

Steve Simon


I attended a conference on quality and patient safety, and some of the speakers mentioned some interesting resources. I googled them and saved the links here.

Patient Quality Indicators. “The Prevention Quality Indicators (PQIs) are a set of measures that can be used with hospital inpatient discharge data to identify quality of care for “ambulatory care sensitive conditions.” These are conditions for which good outpatient care can potentially prevent the need for hospitalization or for which early intervention can prevent complications or more severe disease.” Available at

Clinical classification software for ICD-9-CM. “The Clinical Classifications Software (CCS) for ICD-9-CM is a diagnosis and procedure categorization scheme that can be employed in many types of projects analyzing data on diagnoses and procedures. CCS is based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), a uniform and standardized coding system. The ICD-9-CM’s multitude of codes – over 14,000 diagnosis codes and 3,900 procedure codes – are collapsed into a smaller number of clinically meaningful categories that are sometimes more useful for presenting descriptive statistics than are individual ICD-9-CM codes.” Available at

MedEd Portal. “A peer-reviewed, open-access journal that promotes educational scholarship and dissemination of teaching and assessment resources in the health professions” Available at

Toward stronger evidence on quality improvement. Draft publication guidelines: the beginning of a consensus project. “In contrast with the primary goals of science, which are to discover and disseminate new knowledge, the primary goal of improvement is to change performance. Unfortunately, scholarly accounts of the methods, experiences, and results of most medical quality improvement work are not published, either in print or electronic form. In our view this failure to publish is a serious deficiency: it limits the available evidence on efficacy, prevents critical scrutiny, deprives staff of the opportunity and incentive to clarify thinking, slows dissemination of established improvements, inhibits discovery of innovations, and compromises the ethical obligation to return valuable information to the public.The reasons for this failure are many: competing service responsibilities of and lack of academic rewards for improvement staff; editors' and peer reviewers' unfamiliarity with improvement goals and methods; and lack of publication guidelines that are appropriate for rigorous, scholarly improvement work. We propose here a draft set of guidelines designed to help with writing, reviewing, editing, interpreting, and using such reports. We envisage this draft as the starting point for collaborative development of more definitive guidelines. We suggest that medical quality improvement will not reach its full potential unless accurate and transparent reports of improvement work are published frequently and widely.” Available at

Improving the Quality of Quality Improvement Reporting. Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 Guidelines “SQUIRE provides an explicit framework for those “studying QI” by describing in-depth the improvement interventions, their site-specific contexts, and their results. However, despite endorsement by multiple journals, SQUIRE has not been widely adopted. SQUIRE 2.0, which is the next iteration, has been modified based on significant stakeholder input to simplify and streamline the reporting standards.6 The second version outlines 18 items that should be considered in reporting a QI effort, but allows for flexibility in determining whether each item is necessary or appropriate.” Available at