Understand, in particular, how the performance of adult social care and NHS services are dependent on each other, and that there is a shared imperative to prevent health Indicators tend to be more specifically linked to a clinical condition or disease group in some countries such as Denmark.30. The process of review, seen especially in England, Canada and Australia, is critical to the continued development of performance indicators and their use. When autocomplete results are available use up and down arrows to review and enter to select. At the time of our review, all had made progress in selecting or applying indicators to measure or stimulate improved performance and most had developed a framework for conceptualising performance improvement or indicator use. There are likely to be considerable overlap between the definitions of some of the domains such as effectiveness and appropriateness. Table 3. With the strong encouragement of leading health care agencies, business principles are being implemented throughout health care, including emergency medical services (EMS). For those countries interested in such an extension, it is important to understand what characterises a well performing social health insurance scheme. Indicators are sometimes also used to promote consumer choice at a regional or local level. Effective improvements in health care require methods to evaluate professional practice. To make comparison relevant, all selected countries are OECD members and have been classified by the World Bank as high income.10 Data on the rates of health expenditure and life expectancy for 19 countries were obtained from Australia’s Health 201011 and from OECD reports9 (including Australia, Austria, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, the Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, the United Kingdom and the United States).12 After screening by the research team, the eight countries we noted above were selected for detailed review on the basis that each had made substantial progress in using indicators and developing performance frameworks and had made their indicators and performance frameworks widely available. Australian Government Department of Health and Ageing . Healthcare and Social Assistance KPIs. View or download all content the institution has subscribed to. For consumers, it suggests a direction for making choices on health care … This comprises three performance frameworks: the NHS Outcomes Framework, which focuses on performance and accountability; the Clinical Commissioning Group (CCG) Outcomes Indicator Set aimed at helping the CCG in planning and benchmarking and providing information to consumers and the Quality and Outcomes Framework (QOF) which is a voluntary pay for performance programme for general practice in England.23, The Dutch framework, by comparison, is relatively streamlined and more consumer-focussed. Scotland conceptualised its Quality Measurement Framework on three levels to structure and coordinate the range of measurements that are taken across NHS Scotland. 12). Login failed. You can be signed in via any or all of the methods shown below at the same time. View or download all the content the society has access to. In this study, the eight countries selected for review were using indicators and had implemented a performance framework, several over more than a decade. Table 3 contains a breakdown of indicators by country. In reviewing existing targets and indicators for health and social care, this report considers first what the policy framework for public sector bodies tells us about the aims and objectives of the health and social care system. SAGE Publications Ltd, unless otherwise noted. Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. a number of key performance indicators (KPIs) for assessing the performance of healthcare accreditation programmes in order to contribute to the current knowledge in performance measurement and improvement in public sector and specifically health care. Key performance indicators in healthcare present you with a visual and easy-to-digest means of analyzing your operations. Background: There is continuing demand to demonstrate effectiveness and efficiency in health and social care and to communicate this at boardroom level. Sharing links are not available for this article. Performance indicators are used to observe progress and to measure actual results compared to expected results. Table 1. The atlas is organised according to clinical areas: maternity, demography, cardiovascular disease, gout, polypharmacy and surgical procedures.29 In 2013, the NZ Health Quality and Safety Commission’s campaign Open for Better Care was commenced to measure whether planned changes in practice occur and whether they have resulted in reduced costs and harms.28. A large amount of comparative information about international performance indicators is now available.53 We examined the systems in use in eight countries. The HCP integrated commissioning framework defines KPIs as: Health system performance comparison: an agenda for policy, information and research. Contact us if you experience any difficulty logging in. The health system performance frameworks for each country were reviewed together with their accompanying online and published documentation. However, many countries, even those with advanced data systems, have difficulty linking practice performance to outcomes because of limitations in data availability and poor capabilities to link data. It’s vital to understand how efficiently you are operating while finding areas to improve your services. How do I know if my local council is providing good social care? We conducted our study in four stages. The Care Quality Commission (CQC) introduced a new approach to inspecting and rating health and social care providers in 2013. The role of NICE in England exemplifies a thorough and considered approach to continued indicator development. For example in the Australian PAF, the domain appropriateness is subordinate to, or sub-class of, the domain effectiveness.18 In Canada, these two domains are not grouped, but are classified as separate concepts. Please check you selected the correct society from the list and entered the user name and password you use to log in to your society website. Thus, indicators tend to be developed in a relatively open and transparent way, with input from individuals and stakeholder organisations. Table 2. Nationwide continuous quality improvement using clinical indicators: the Danish National Indicator Project, Connections between quality measurement and improvement, Clinical indicators in accreditation: an effective stimulus to improve patient care, Performance management in healthcare: part II – state of the science findings by stage of the performance measurement process, Using performance indicators to improve health care quality in the public sector: a review of the literature, What’s measured is what matters: targets and gaming in the English public health care system, Does providing feedback on patient-reported outcomes to healthcare professionals result in better outcomes for patients? For more than two decades, regulators, policymakers, researchers and clinicians have endeavoured to improve the quality of healthcare by designing and applying indicators of performance. The National Skills Academy for Social Care (NSASC), part of Skills of Care, and the NHS Employers Organisation (NHS E), have been commissioned by the Department of Health to produce an online hub to support line managers in health and social care in the effective performance management of … The population health approach: A qualitative study of conceptual and operational definitions f... Identifying the key performance improvement domains for home health agencies. Concepts that focus on both health promotion and risk reduction are included in the performance indicators. Hibbert, P, Hannaford, N, Long, J. Performance indicators are published for all 150 council-run social services departments in England. Meanwhile, in the Netherlands, a report detailing results for all 125 indicators is published every 2 years.38 From 2011, the information was updated via a website twice a year and from 2014, the report will be published every 4 years.38 The indicators are reported at the national level, not locally. The focus of this set of indicators is directed towards the question how care homes can measure and manage improvements with regard to the quality of life of their clients, and the related issues of quality of care, management, economic performance and relationships with external stakeholders. As part of its Strategic Plan 2012–2015,16 NHPA is required to regularly review its Performance and Accountability Framework (PAF) to ensure it remains relevant and continues to address the needs of the Australian public for high-quality healthcare. The purpose of the table was to compile an initial ‘long-list’ of available indicators and then to identify a ‘short-list’ of those reported in multiple countries. Organisation for Economic Co-operation and Development . Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire populations. For more information view the SAGE Journals Sharing page. Comprehending each patient’s stay, how long they must wait for services, and how they perceive you can lead to valuable BI insights and actionable results. A review of the evidence, Australian Institute of Health Innovation, University of New South Wales, Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. NICE is responsible for managing the development process of clinical and public health indicators for the QOF and the CCG indicator sets.31 NICE also recommends whether the existing indicators should continue to be part of the frameworks. NICE has developed guides,32,33 which set out in detail the processes involved in managing the development of indicators. Of the 11 frameworks published in five countries and the OECD, the most frequently used (self-reported) domains were effectiveness (eight), access and safety (seven each) and efficiency (five; Table 2). The performance indicators were subjected to a detailed assessment and were classified according to whether they applied to community/hospital/population, country of origin and clinical specialty. There are two dedicated websites that provide consumers of healthcare with information about the quality of a service and provide ratings for their service.39 These are Independer – www.independer.nl – and Kiesbeter – www.kiesbeter.nl or ‘Choose Better’. As such you will probably find that you are already using KPIs in your practice, but perhaps you don’t realise it. Cordasev, H, Arne Björnberg, M, Hjertqvist, O. Raleigh, VS, Foot, C. Getting the measure of quality: opportunities and challenges. Of these, 45 indicators are reported in more than one country. the family in terms of performance of social roles. There appears to be considerable overlap between the definitions of many of the domains such as effectiveness and appropriateness. We classified the indicators, where possible, into major disease groups (Table 5). Canadian Institute for Health Information . I have read and accept the terms and conditions, View permissions information for this article. Most of the eight countries have an overarching framework for the selection and reporting of indicators which establish the broader aims for their implementation activity and play a large role in indicator selection and use. People performance management is important and doing it well has a big impact on the quality of care that your service provides. FundingThis work was supported, in part, by the National Health Performance Authority, Australia (but no one including the Authority’s officers had a role in the study, its conduct, results, interpretation or publication of this article) and the National Health and Medical Research Council (APP1054146). important role in achieving our mission to provide excellent and efficient services working in partnership with residents and the wider local community The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. Regular review of the performance framework and indicators is conducted in most of the eight countries by government or government-funded, arm’s-length bodies. Performance indicators are quantitative tools and are usually expressed as a rate, ratio or percentage. We selected eight prominent health systems for review and assessment based on purposively selecting a sample that were exemplars in using indicators and making their data and performance systems available: Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Publication date: 2005 You should remember that performance management isn’t just about issues – it’s also key to motivating, supporting and encouraging hardworking staff. We searched for relevant performance indicators and their domains across the eight countries. KPI is a measure used to define and evaluate how successful an organization is. Similarly, in Denmark, clinical indicators are reported, and a structured audit process is initiated every 6 months by audit groups of clinicians at national, regional and local levels to explain the risk-adjusted results and to plan improvements. Vision and Strategy for Adult Social Care and Health; What to do if you have changed, or are planning to change, your Care Quality Commission registration; Local Performance Account reports. These sample KPIs reflect common metrics for both departments and industries. Few studies make comparative assessments of different countries’ performance indicator frameworks. Languages: English. These standards are overseen by the International Society for Quality in Healthcare (ISQua).22 The Danish National Indicator Project (DNIP) merged with the Clinical Quality Development Programme (RKKP) in 2010.8 Although Denmark lacks a formal framework, the DNIP manual outlines the thinking behind its clinical indicators and planned future indicators (1) to improve prevention, diagnostics, treatment and rehabilitation; (2) to provide documentation for setting priorities and (3) to create an information resource for patients and consumers. Devising primary care performance indicators for New Zealand, A conceptual framework for the OECD Health Care Quality Indicators Project, Primary health care reform in Australia – report to support Australia’s first National Primary Health Care Strategy, 2011 National healthcare quality and disparities reports, Rising to the challenge – results from a scorecard on local health system performance, Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement, Correlates of health and healthcare performance: applying the Canadian health indicators framework at the provincial-territorial level, International profiles of health care systems, Developing a national performance indicator framework for the Dutch health system, Health care performance in the Netherlands: easy access, varying quality, rising costs, OECD reviews of health care quality: Denmark: executive summary, assessment and recommendations, About the Quality and Outcomes Framework (QOF), Unintended consequences of performance measurement in healthcare: 20 salutary lessons from the English National Health Service, Health indicators 2013: definitions, data sources and rationale, Canadian Hospital Reporting Project technical notes – clinical indicators, Healthy Canadians: a federal report on comparable health indicators. This can be seen in the reporting on Canada’s health system performance, where various indicators are reported via multiple channels. This product could help you, Accessing resources off campus can be a challenge. Of these, 45 indicators are reported in more than one country. At the time of the study, this provides advanced indicators and applies them throughout the country. National Institute of Public Health and the Environment . The NHS Outcomes Framework 2012/13. The authors would like to thank their colleagues Dr Diane Watson, Bernie Harrison, Jessica Stewart, Dr Julia Langton, Jason Boyd, Jessica Herkes and Kristiana Ludlow for their support to the project. Definitions for these domains are often not explicit in the policy documents.20 Definitional consistency between countries should be the subject of more research or efforts to internationally standardise. Table 4. A scoping table detailing the indicators by country was developed. The framework first illustrates how performance in the health financing functions of revenue collection, pooling and purchasing affects the realisation of health financing targets of resource generation, optimal resource use and financial accessibility of health services for all. Key Performance Indicators define factors the institution needs to benchmark and monitor. We’ve assembled a collection of sample Key Performance Indicators for you to use as a starting point when building scorecards. For more information view the SAGE Journals Article Sharing page. 1.2.2 Recognize that there are multiple dimensions of health. This site uses cookies. NI125, NI127, NI130, NI145, NI146, NI149 and NI150 will appear in the new framework, although there will be some small changes to the definitions. Lean Library can solve it. Following this, we analysed performance indicators that were nationally consistent (used across the country rather than just regionally), locally relevant (measured and reported publicly at a local level, for example, a health service) and measured patient-level metrics. A performance indicator is not a synonym for quality, but rather a proxy. Institute of Medicine . The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. The quality of health care is on the agenda in most health care systems. 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