How (and why) do quality improvement professionals measure performance?

The era of value-based care has engulfed healthcare delivery systems around the world. Pediatricians are especially challenged by constrained resources for providing care to our vulnerable population, and methods for achieving value for children through improved quality and reduced cost of care are crucial for success. This paper examines the use of measures to determine the two components of the value proposition: quality and cost. The implications for adopting Lean Six Sigma as an improvement paradigm are reviewed, and the case for using these concepts is detailed with examples of measures used in health systems in the United States and several other countries.