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Editor's Note |

Performance Measures:  Better Outcomes, Not Better Grades

Rita F. Redberg, MD, MSc
JAMA Intern Med. 2013;173(16):1549. doi:10.1001/jamainternmed.2013.7769.
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Performance measures are widely used with the goal of improving care of patients with heart failure and other illnesses. This study by Dharmarajan et al illustrates that performance measures may sometimes have unintended consequences. The authors show that in the enthusiasm to achieve the measure of placing patients with heart failure on β-blocker therapy at hospital discharge, many patients who should not receive β-blockers are getting them, while others who meet the criteria are not. It is likely that there was more thoughtful discussion and decision making behind these decisions that is not captured in administrative data used for this analysis. However, it must also be remembered that the purpose of performance measures is to improve patient care, not to get high grades. Too much focus on meeting a target can distract us from the care of the whole patient.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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