How to cite this paper:

Martin LA, Nelson EC, Lloyd RC, Nolan TW. Whole System Measures. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2007. (Available on www.IHI.org)

This white paper describes and promotes the use of a system of metrics, called the Whole System Measures, to measure the overall quality of a health system and to align improvement work across a hospital, group practice, or large health care system. The Institute for Healthcare Improvement and colleagues developed the Whole System Measures, a balanced set of system-level measures, to supply health care leaders and other stakeholders with data that enable them to evaluate their health systems’ overall performance on core dimensions of quality and value, and that also serve as inputs to strategic quality improvement planning.

Properly constructed, the Whole System Measures should complement existing measures that organizations use to evaluate the performance of their heath care systems. The Whole System Measures, because they are intended to focus on important system-level measures, are limited to a small set of 13 measures that are not disease- or condition-specific. One objective for developing the Whole System Measures was to also provide a view of performance that reflects care provided in different sites — both inpatient and outpatient — and across the continuum of care.