The environmental scan is essential in building the case for a quality measure. A broad-based environmental scan should include a strong review of literature, regulatory environment, economic environment, and interested party needs and capabilities. Performing a comprehensive environmental scan will improve the likelihood of project success. 

Among the many important areas to scan, measure developers must consider the six domains of quality, outlined in Crossing the Quality Chasm (2001), which include safety, timeliness, efficiency, effectiveness, equitability, and patient centeredness. Also refer to the Meaningful Measures Initiative, which identifies the priorities for quality measurement and improvement. 

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The resulting report of the environmental scan will reflect the example data sources depicted in the graphic:

• Identification of related or competing measures, including opportunities for consolidation, harmonization, and alignment
• Listing of clinical guidelines pertinent to the clinical domain or topic
• Review of studies that document the success of measures in the same or similar health care setting or domain
• Discussion of scientific evidence supporting clinical solutions that might serve as a basis for the measure
• A review and evaluation of peer-reviewed and grey literature
• An assessment of clinical practice guidelines, legislation and regulations, and their implications on measurement
• The study of clinical decision support artifacts
• A list of existing related and competing measures
• A review of empirical data
• Discussion of expert input (including input from the technical expert panel and other experts)
• A summary of stakeholder input—inclusive of all relevant stakeholders, including patients and caregivers