Accurately measuring quality is extremely difficult in healthcare. Any measure of quality will come with limitations. For example, measuring on outcomes (e.g. hospital readmission rates) doesn't take into account factors outside of the provider's control, such as patient behavior. Measuring on process (e.g. staffing ratios) doesn't take into account needs to adapt to individual situations. Just ask a doctor how they feel about "cookbook medicine". You could also measure on patient feedback. They are the consumers, after all. However, do they really understand whether or not they were given good care? Don't patients seek out professional healthcare providers precisely because they don't understand what is needed?

Attached is an article outlining quality measurement challenges for a unique case. I would like input from each of you on the best way to handle this. In your opinion, what would be the best way to measure quality for this? What limitations might there be to your measurement?

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0161