Table 2.

Selected Practical Applications of Principles for Primary Care Quality

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