Improving health care, Part 1: The clinical value compass.

E. C. Nelson*, J. J. Mohr, P. B. Batalden, S. K. Plume

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

132 Scopus citations


CLINICAL VALUE COMPASS APPROACH: The clinical Value Compass, named to reflect its similarity in layout to a directional compass, has at its four cardinal points (1) functional status, risk status, and well-being; (2) costs; (3) satisfaction with health care and perceived benefit; and (4) clinical outcomes. To manage and improve the value of health care services, providers will need to measure the value of care for similar patient populations, analyze the internal delivery processes, run tests of changed delivery processes, and determine if these changes lead to better outcomes and lower costs. GETTING STARTED--OUTCOMES AND AIM: In the case example, the team's aim is "to find ways to continually improve the quality and value of care for AMI (acute myocardial infection) patients." VALUE MEASURES--SELECT A SET OF OUTCOME AND COST MEASURES: Four to 12 outcome and cost measures are sufficient to get started. In the case example, the team chose 1 or more measures for each quadrant of the value compass. OPERATIONAL DEFINITION OF MEASURES: An operational definition is a clearly specified method explaining how to measure a variable. Measures in the case example were based on information from the medical record, administrative and financial records, and patient reports and ratings at eight weeks postdischarge. COMMENTS: Measurement systems that quantify the quality of processes and results of care are often add-ons to routine care delivery. However, the process of measurement should be intertwined with the process of care delivery so that front-line providers are involved in both managing the patient and measuring the process and related outcomes and costs.

Original languageEnglish (US)
Pages (from-to)243-258
Number of pages16
JournalThe Joint Commission journal on quality improvement
Issue number4
StatePublished - Apr 1996

ASJC Scopus subject areas

  • Leadership and Management


Dive into the research topics of 'Improving health care, Part 1: The clinical value compass.'. Together they form a unique fingerprint.

Cite this