The use of patient-based instruments to measure, manage, and improve quality of care in dialysis facilities

Continuous quality improvement requires analysis of data and the variation in those data to improve the process of care. Traditionally, physicians assign a higher value to quantitative data gathered from laboratory and physiologic testing than to data gathered from querying patients. There is a growing literature validating the use of patient-assessed health status as primary data in measuring and managing quality improvement. There are a range of patient-assessed data, from simple "complaints" to psychometrically validated health status instruments. Each has its own use. Each are increasingly available for use in the routine conduct of care. Patient-assessed health status predicts important outcomes of care such as death, hospitalization, depression, and physical capacity. Providers can use them to plan acid monitor care. The ongoing challenge is to align the patients' expectations for issues related to process of care with issues associated with outcomes of care. (C) 2001 by the National Kidney Foundation, Inc.