• J Gen Intern Med · Jan 2023

    Editorial

    Directly Observed Care: Crossing the Chasm of Quality Measurement.

    • A Taylor Kelley, Saul J Weiner, and Joseph Francis.
    • Vulnerable Veteran Innovative Patient Aligned Care Team (VIP) Initiative, Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA. Alan.Kelley@hsc.utah.edu.
    • J Gen Intern Med. 2023 Jan 1; 38 (1): 203207203-207.

    AbstractAfter more than two decades of national attention to quality improvement in US healthcare, significant gaps in quality remain. A fundamental problem is that current approaches to measure quality are indirect and therefore imprecise, focusing on clinical documentation of care rather than the actual delivery of care. The National Academy of Medicine (NAM) has identified six domains of quality that are essential to address to improve quality: patient-centeredness, equity, timeliness, efficiency, effectiveness, and safety. In this perspective, we describe how directly observed care-a recorded audit of clinical care delivery-may address problems with current quality measurement, providing a more holistic assessment of healthcare delivery. We further show how directly observed care has the potential to improve each NAM domain of quality.© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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