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PSNet: Patient Safety Network
Journal Article

Identifying unintended consequences of quality indicators: a qualitative study.

Lester HE, Hannon KL, Campbell SM. BMJ quality & safety. 2011;20:1057-61.

This qualitative study conducted with focus groups of British general practitioners identified four potential unintended consequences of new quality measures: measure fixation (overemphasis of specific aspects of care), tunnel vision (missing important contextual information due to focusing on measures), misinterpretation of metrics, and potential for gaming measurements to inflate achievement.