Performance measures are critical to identify areas of improvement, as well as support improvement efforts that lead to positive results. Using performance measures will make the most of your efforts by focusing them on what matters most. Performance measures were designed to give a snapshot of the care being delivered. With a combination of numerator and denominator patients, performance measures can be used to paint a picture of how our work is going and what we can do better.
If you are responsible for measuring and improving patient health outreach, then you absolutely need to be aware of how numerators and denominators are constructed. The wrong choice here can lead to misleading data that can give management the wrong impression about the quality of a program. So, when you're setting up new goals and measures, make sure you understand the ins and outs of calculating numerator and denominator values.
It might take a little time to wrap your brain around is figuring out which patients to include in the numerator and denominator. That just requires assessing which patients should be able to receive the care or service under review and determining how you want to define them. The determinate and the population are two important criteria to be used in the assessment of client data. The determinate establishes which clients should be added to the numerator and which should not. The population determines which group of clients should be included within the denominator and which should be excluded.
How should you identify numerators and denominators? The answer, as it turns out, depends on the circumstances. You may have a situation where you need to track numbers in either direction. What this means is that you will need to be able to recognize when one group is appropriate, and when another group is better suited.
For the Denominator, identify the clients that received the care or service under review. For each performance measure an eligible population must be determined. Depending on the element of care being measured, certain patients should be excluded from the denominator to gather accurate data. For instance, if you would like data for adult females who received a vaccine, the exclusion for the denominator would be anyone under the age of 18 years old and any patient with a gender of male. The Denominator will include all adult females over the age of 18 years old.
The Numerator is always a subset of the data in the Denominator. The Numerator is the number of people in the denominator that met the criteria. Keeping to the example above, the numerator is the number of adult females from the denominator who received a vaccine.
In summary, the denominator, identify those patients who should receive the care or service under review. The numerator includes those patients who should have received the care and did receive the care. Performance measures have value when used as a tool to compare practice with peers or identify problem areas that make a change of care necessary.