Keeping the Good in Goodhart's Law: Bridging Key Performance Indicators to Comprehensive Medication Management

The Clinical Administration Practice and Research Network (CADM PRN) developed 15 candidate key performance indicators (KPIs) for clinical pharmacy practice using a modified Delphi process [1].The authors posit that KPIs are necessary for benchmarking, optimizing patient outcomes, supporting financial sustainability, and justifying appropriate staffing.The proposed KPIs are readily measurable and plausibly linked to relevant outcomes: examples include IV-to-PO conversion, pharmacist discharge reconciliation, guideline-concordant VTE prophylaxis, and daily pharmacist review.The authors also cite Goodhart's Law ("when a measure becomes a target, it ceases to be a good measure") and McNamara's Fallacy ("not everything that can be measured is important and not everything that is important can be measured") as essential implementation guardrails.