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Table 1 Definition of terms

From: Guideline-based quality assurance: a conceptual framework for the definition of key elements

1. Quality indicators (may also be conceptualized as quality markers/quality constructs/quality parameters)
Purpose: to address specific aspects of the quality of healthcare [3].
Definition: quality indicators are constructs that relate to structures, processes or outcomes of care, and are used to monitor, evaluate, and improve the quality of care. They can then be used to identify gaps in the quality of care, with potential for quality improvement. Quality indicators can be translated into performance measures allowing for rate-based measures (e.g., numerator and denominator) and can be utilized to assess the quality of screening, diagnosis, management, and/or care programmes, and, to develop tools to implement strategies for quality improvement.
In the context of clinical guideline development, quality indicators should be based on people important outcomes selected for the healthcare questions included in the guidelines (health status indicators).
Other indicators, sometimes (validated) surrogates, that represent population-based net benefits, e.g. existence of an organised screening programme or participation in screening programmes may also have to be established in order to guarantee that structures and processes are appropriate (structure and process indicators)
2. Performance measures (may also be conceptualized as performance tools or performance instruments)
Purpose: to quantify the performance of healthcare associated with a quality indicator.
Definition: performance measures are tools or instruments to quantify or describe measurable elements of practice performance. Performance measures should attempt to measure performance that is directly attributable to a healthcare organization, a team or single actor, but not to independent environmental factors (that is, they avoid confounding by environmental factors).
3. Performance indicators (may also be conceptualized as performance estimates)
Purpose: to monitor aspects of health care performance associated to a quality indicator such as effectiveness, efficiency, and safety [13].
Definition: performance indicators are quantifiable or measurable units or scores of practice. Performance indicators allow setting thresholds, ranges or other targets to permit comparisons and evaluations of practice performance that is directly attributable to a healthcare organisation, a team, or single actor.