How Quality Scores Are Calculated

Every quality number in Theator — a case's practice result, an SPEQ result, and a Quality Initiative's Adoption Rate — is built from one simple decision made on each case: was the best practice performed, yes or no. This article explains how that per-case decision rolls up into the percentages you see, and what the X out of N numbers on an initiative mean.

How each practice is scored on a case

For every case a best practice applies to, Theator scores that practice once, as a yes/no result:

• Performed -- the best practice was followed in this case. You may also see this called met or achieved.
• Not Performed -- the best practice was not detected in this case. On the case page these practices appear in a Not achieved list, which only admins and venue admins can display.

A case that the practice does not apply to, or that has not been evaluated for it, gets no result and is not counted.

Scoring is binary at the case level: a case either followed the practice or it did not. There is no partial credit within a case. This is why, in a Quality Initiative, it is cases that are counted.

What the "X out of N" numbers on an initiative mean

An initiative page shows two kinds of fractions, and they count different things.

• Cases -- In the adoption table, each cell shows a percentage and a case count such as (19 out of 22): the cases where that practice was performed, out of the cases it applied to, for that participant. A practice's Analytics page in the catalog shows the same pair as Performed and Relevant cases.
• Practices that reached their goal -- Current adoption shows, for example, 1 out of 2 surgical practices reached target. Each practice in an initiative has its own adoption goal, and this number counts how many of the initiative's practices are currently at or above their goal. Started at shows the same count at the start of the initiative. The same count appears under each participant's name (1 out of 2 reached target) and in the initiatives list as 1/2 Goals.

So a 1 out of 2 on an initiative never means that a case was half-performed. It means that one of the initiative's two practices has reached its goal and the other has not yet.

How the Adoption Rate is calculated

An initiative's Adoption Rate is a percentage of cases:

Adoption Rate = cases where the practice was performed ÷ eligible cases

• Eligible cases are the cases the practice applied to (the denominator). A practice's Analytics page calls these Relevant cases.
• Cases where the practice was performed are the eligible cases scored Performed (the numerator).

Because the count is of cases, the numerator and denominator are always whole numbers of cases — for example, 19 of 22 cases. Each case contributes one result: performed or not performed. A case that an admin or venue admin has excluded from a practice's statistics is not counted.

Why the Adoption Rate changes over time

A Quality Initiative measures the cases that fall inside its time window, and the Adoption Rate is recalculated as new cases are recorded and processed. As more eligible cases arrive, both the numerator and the denominator grow.

That is why a rate can move from, say, 15 of 16 cases to 19 of 22 cases without any earlier case changing its result — six more eligible cases were measured, four of them performed and two not performed. Early in an initiative the rate is based on only a handful of cases, so expect it to shift as case volume grows and to settle as the window fills in.

Changing the date range you are viewing, or an initiative's start date, also changes which cases are counted.

What's Next?

• What is an SPEQ? — Where per-case practice results appear on the case page and who can see them
• Manage Quality Initiatives — Track adoption rates and trends for a best practice over time
• Exploring Best Practices and the Catalog — Browse the best practices library and their adoption rates