Quality Measures for Patients at Risk of Adverse Outcomes in the Veterans Health Administration: Expert Panel Recommendations

Evelyn T. Chang
Sydne Newberry
Lisa V. Rubenstein
Aneesa Motala
Marika J. Booth
Paul G. Shekelle
Peer-Reviewed Article
August 2022


Recommended set of evidence-based measures for high-quality care for patients with complex needs based on systematic review of relevant measures.


While many health care stakeholders have focused on improving care for patients at high risk of adverse health outcomes, there is minimal guidance on how to measure high-quality care for these patients. Given the heterogeneity of this patient population, relevant measures should apply to multiple chronic conditions. An expert panel responded to a systematic review of measure concepts. 


The expert panel selected the following evidence-based measure concepts as being the highest priority to improve care for patients at high risk of adverse outcomes: caregiver availability and support; vaccinations; housing instability; physical function; depression symptoms; cognitive impairment; prescription regimen; primary care follow-up after an emergency department visit or hospitalization; and timely transmission of discharge information to primary care.


These selected quality measures can inform the design and reporting of quality improvement initiatives in complex care, as they are broadly relevant to patients at high risk of adverse health outcomes.

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