Pronovost: Surveillance Bias Threatens Quality Payment Fairness

2. Costs and benefits of proposed measures should include rational prioritization of which measures to mandate. "Policymakers could require a formal post hoc review evaluating the risks, benefits and harms of the outcome measures after implementation."

3. Performance measures could link a process of care with adverse outcomes when defining incidence of preventable harm. "When standardized surveillance is too costly or risky, processes of care among those sustaining the outcome could be examined. For example, what percentage of patients who develop a DVT (outcome) received appropriate risk assessment and prophylaxis (process)?"

Pronovost this month was named director of the newly established Armstrong Institute for Patient Safety and Quality at Johns Hopkins. He was simultaneously named Johns Hopkins Medicine’s senior vice president for patient safety and quality.