Building a Culture of Safety and Quality: The Paradox of Measurement.

Performance measures and quality metrics are widely used in health care. Yet, evidence has shown conflicting results as to whether this type of measurement consistently leads to improvements in quality of care and patient outcomes. The aim of this study was to examine U.S. emergency and intensive care nurses' experiences with measurement-driven clinical behavior, with a focus on measurement-driven harm. Qualitative analysis revealed three major interacting categories of negative, unintended consequences of performance measurement: overtreatment and unnecessary care, undertreatment, and inefficiency. The resulting framework is offered to support nursing leaders' efforts to enhance safety and quality, minimize measurement-related harm and inefficiencies, and contribute to the positive evolution of performance measures in health care. [ABSTRACT FROM AUTHOR]

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