Core Principles to Improve Primary Care Quality Management

Article Figures & Data

Table 1.

Four Foundational Principles for Quality Management in Primary Care

Principle 1 (Cornerstone): The singular objective of quality management in primary care is to improve the health of patients and populations.	A Bridge Across the Chasm	Principle 3: Measurements are tools for quality, not outcomes of quality.
Principle 2: The Quadruple Aim is a dynamic whole, not a sum of its parts.	A Bridge Across the Chasm	Principle 4: Quality outcomes in primary care depend on therapeutic relationships.

Table 2.

Selected Practical Applications of Principles for Primary Care Quality

Principles	Practices
Principle 1: The singular objective of quality measurement in primary care is to improve the health of patients and populations.	Translating patient-centered and patient-reported outcomes from research into clinical practice⁵⁸
	Applying population health metrics
	Designing appropriate risk adjustments for the social determinants of health
Principle 2: The Quadruple Aim is a dynamic whole, not a sum of its parts.	Anticipating financial, social capital, and opportunity costs of measurement schemes
	Harnessing patient and provider experiences of care as core metrics
	Optimizing electronic medical records to simplify measurement and reporting,⁵⁹ accurately reflecting the “lived narrative” of patient and provider
Principle 3: Measurements are tools for quality, not outcomes of quality.	Extending reporting periods from one to three years
	Improving parsimony in measurement sets
Principle 4: Quality outcomes in primary care depend on therapeutic relationships.	Decentralizing authority over metrics
	Prioritizing intrinsic over extrinsic quality management systems⁶⁰
	Sharing decision making over health goals³⁸
	Integrating psychosocial and community interventions into quality outcomes