Health system frameworks and performance indicators in eight countries: A comparative international analysis, http://www.creativecommons.org/licenses/by-nc/3.0/, https://us.sagepub.com/en-us/nam/open-access-at-sage, http://www.oecd-ilibrary.org/economics/country-statistical-profile-australia_20752288-table-aus, http://data.worldbank.org/income-level/OEC, http://apo.org.au/files/Resource/NPHC-supp.pdf, http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr11/measurespec/patient_centeredness.html, http://www.commonwealthfund.org/About-Us/Foundation-History.aspx, http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2012/Mar/Local%20Scorecard/1578_EXEC_SUMM_Commission_rising_to_challenge_local_scorecard_2012_FINAL.pdf, http://www.nhpa.gov.au/internet/nhpa/publishing.nsf/Content/About-us, http://www.comlaw.gov.au/Details/C2011C00952, http://www.nhpa.gov.au/internet/nhpa/publishing.nsf/Content/Performance-Indicator-Reporting, https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC2195&lang=fr, http://www.commonwealthfund.org/Publications/Fund-Reports/2012/Nov/International-Profiles-of-Health-Care-Systems-2012.aspx, http://www.health.govt.nz/new-zealand-health-system/health-targets/about-health-targets, http://www.health.govt.nz/our-work/primary-health-care/primary-health-care-subsidies-and-services/pho-performance-programme-and-transition-integrated-performance-and-incentive-framework, http://www.open.hqsc.govt.nz/open/about-the-campaign/, http://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/projects/atlas-of-healthcare-variation/, http://www.oecd.org/els/health-systems/ReviewofHealthCareQualityDENMARK_ExecutiveSummary.pdf, http://www.nice.org.uk/standards-and-indicators/qofindicators, https://www.nice.org.uk/standards-and-indicators/How-we-develop-QOF, http://www.statcan.gc.ca/pub/82-221-x/2013001/tbl-eng.htm, http://publications.gc.ca/collections/collection_2013/icis-cihi/H118-86-1-2013-eng.pdf, http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2010-fed-comp-indicat/index-eng.php, http://www.rivm.nl/en/Documents_and_publications/Scientific/Reports/2012/april/Dutch_Health_Care_Performance_Report, http://www.healthpowerhouse.com/files/HCP-study-Best-hospital-final-101119.pdf, A review of the Australian healthcare system: A policy perspective. Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire populations. These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets. KPIs, which are specific and measurable elements of health and social care, can be used to assess the quality of care. Australia’s health 2010 (Australia’s Health Series No. 1.2.2 Recognize that there are multiple dimensions of health. NICE has developed guides,32,33 which set out in detail the processes involved in managing the development of indicators. These sample KPIs reflect common metrics for both departments and industries. 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. 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. 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. The email address and/or password entered does not match our records, please check and try again. 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). A performance indicator is not a synonym for quality, but rather a proxy. 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. Shekelle, P, Lim, Y-W, Mattke, S. Does public release of performance results improve quality of care? Other indicators of family health could be extrapolated from the addi-tional concepts that King identified as impor-tant for understanding social systems: orga- NI125, NI127, NI130, NI145, NI146, NI149 and NI150 will appear in the new framework, although there will be some small changes to the definitions. We conducted our Internet search of performance indicator systems in the eight comparator countries in May 2013. This can be seen in the reporting on Canada’s health system performance, where various indicators are reported via multiple channels. 3. 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 … Key performance indicators (KPIs) are just that, indicators that tell us how we are performing on the things that we think are important, or key, in our practice. KPI is a measure used to define and evaluate how successful an organization is. Simply select your manager software from the list below and click on download. 4. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. One tool that is frequently used to assist in performance monitoring and which can subsequently contribute to performance improvement in quality and safety, is the development and monitoring of key performance indicators (KPIs). However, it is difficult to gauge how many indicators are in use, because only certain indicators are selected for inclusion in the annual reports and there appear to be various degrees of overlap. The population health approach: A qualitative study of conceptual and operational definitions f... Identifying the key performance improvement domains for home health agencies. Secondly, it reviews the evidence as to how we might develop targets and indicators as Cardiovascular, surgery and mental health were the most frequently reported disease groups. Although we presented the self-reported domains by country, consistency of definitions between countries and the level of semantic overlap was not tested; however, these are likely to be substantial. It’s vital to understand how efficiently you are operating while finding areas to improve your services. However, only of late has systematic evidence about quality of care begun to be collected in most health care syst… the Association of Directors of Adult Social Care (ADASS) and the Chartered Institute of Public Finance and Accountancy (Cipfa)). A particular characteristic or dimension used to measure intended changes defined by an organisational unit’s results framework. 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. 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. Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. 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. Nationally consistent and locally relevant indicators by disease group. The paucity of research examining the links between indicators and improvement may be due to the difficulty in attributing change to any particular policy initiative or intervention.49, The literature supports the use of performance indicators, suggesting that their impact is more likely to be on provider rather than consumer behaviour.43,50 However, there is a general call for more good quality studies on impact.50–52. 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. Approached in this way, performance management can promote excellence in service delivery and result in a more highly motivated and involved workforce. While some of the indicators are the same as those listed by SC, there are some additional hospital performance indicators (21 in total).36 Additionally, the Government of Canada37 has a candidate list of 70 indicators that were approved for use by Federal, Provincial and Territorial Ministers of Health in 2004. Few studies make comparative assessments of different countries’ performance indicator frameworks. After the audit process is complete, the data are released publicly, including comments on the results from the audit groups.40 Reports on many of the indicators are available on the www.sundhed.dk website. Indicators tend to be more specifically linked to a clinical condition or disease group in some countries such as Denmark.30. The quality of health care is on the agenda in most health care systems. Typically is expressed in term… While there is no single integrated framework, the AHRQ measures health system performance across four dimensions13 and the Commonwealth Fund aims to be a catalyst for change by identifying promising practices to help the United States create a high-performing healthcare system.14 The Commonwealth Fund spans four dimensions of health system performance: access, including insurance and affordability of care; prevention and treatment, including quality of ambulatory, acute, post-acute and palliative care; avoidable hospital use and cost, such as care that could have been avoided if the patient received appropriate care initially; and indicators assessing the extent to which people can enjoy long and healthy lives.15. Two dimensions of indicators – that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) – were deemed important. The NHS Outcomes Framework 2012/13. England and Canada do the most extensive research and development work to select indicators. Of these, 45 indicators are reported in more than one country. When autocomplete results are available use up and down arrows to review and enter to select. Table 5. Final report: performance indicators used internationally to report publicly on healthcare organisations and local health systems. Some society journals require you to create a personal profile, then activate your society account, You are adding the following journals to your email alerts, Did you struggle to get access to this article? The role of NICE in England exemplifies a thorough and considered approach to continued indicator development. The Organisation for Economic Co-operation and Development (OECD) publishes 60 internationally comparable indicators of healthcare quality.9 These are useful and influential. For monitoring long-term progress, there are 12 Quality Outcome Indicators (QOIs) which do not have specific targets; short-term priority areas are focussed on by the ‘HEAT’ targets: Health improvement for the people of Scotland (H), Efficiency and governance improvements (E), Access to services (A) and Treatment appropriate to individuals (T); and the third category includes all other national and local reporting requirements. The Canadian framework has two main goals: to determine (1) the health of Canadians and (2) how well the health system performs and operates according to the published principles of providing reports that respect Canadians’ privacy and are also consistent, relevant, flexible, integrated, user-friendly and accessible.19,20 The indicator framework is conceptualised in terms of the provision of high-quality comparative information across four dimensions. For example, the Health Indicators 2013 report20 provides results for 88 indicators, 13 of which were additional indicators chosen to be included to measure performance by socioeconomic status at provincial and national levels.20 Although this appears confusing from an external perspective, variable reporting may be more effective in some instances, as CIHI addresses reporting needs by acknowledging different audiences and tailoring reporting for their requirements. Table 4. Indicators reported locally (at regional levels) occur via the Dutch Hospital Database. CMH Community Mental Heath (CMH) Domain 1 - Enhancing the quality of life for people with care and support needs 40% 46% 5% At the time of the study, this provides advanced indicators and applies them throughout the country. Aims: The aim of this study was to gain consensus on key performance indicators that are appropriate and relevant for nursing and midwifery practice in the current policy context. There were 101 performance indicators listed on the SC website.35 The CIHI also has indicators listed under the Canadian Hospital Reporting Project (CHRP). Australian Institute of Health and Welfare . Braithwaite, J, Matsuyama, Y, Mannion, R. Healthcare reform, quality and safety: perspectives, participants, partnerships and prospects in 30 countries. You should remember that performance management isn’t just about issues – it’s also key to motivating, supporting and encouraging hardworking staff. Table 1. 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 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. Then, within each health financing function, key performance issues and associated measurable indicators are developed. It is broadly agreed that monitoring performance imposes an inherent pressure on healthcare organisations or services to improve practice.48 However, the extent to which this is accomplished is disputed and under-researched. Staff-To-Patient Ratio: Indicates the use and capacity of staff resources, which can affect the quality … We searched for relevant performance indicators and their domains across the eight countries. A scoping table detailing the indicators by country was developed. The description of the indicators therefore also Assessing commonalities and differences between indicator specification and application in comparable health systems may be of value to regulators, policymakers, researchers and clinicians and forms a foundation for further research into the practical impact of indicators on the quality of healthcare. Domains within the performance frameworks were compared. 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? Domains of performance indicators by country. Local Performance Account Reports. The Care Quality Commission (CQC) introduced a new approach to inspecting and rating health and social care providers in 2013. Contact us if you experience any difficulty logging in. Find out about Lean Library here, If you have access to journal via a society or associations, read the instructions below. By continuing to browse Performance Indicators* Pre-K-Grade 2 1.2.1 Identify that healthy behaviors impact personal health. Institute of Medicine . 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. National minimum standards for certain services in social care, national occupational standards and codes of practice are shaping the performance management framework in the social care sector. Indicators that were collected consistently on a national scale were included, but could be relevant and useful to local quality improvement efforts. This article provides a simple framework to analyse key performance issues related to the functions of health financing within the context of social health insurance. Cordasev, H, Arne Björnberg, M, Hjertqvist, O. Raleigh, VS, Foot, C. Getting the measure of quality: opportunities and challenges. The importance of a logical, universally acceptable and viable conceptual framework to underpin development of a national performance indicator set is also emphasised in the literature.41,42 A conceptual framework sets out the rationale and design principles for the indicator set and links it to the wider health system context. 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. Australian Government Department of Health and Ageing . Table 3. The supervisee should prepare for the supervision and have a copy of the agenda set out from the last meeting, 4 Be able to provide professional supervision in health and social care or children and young people s work setting 4.1Support supervisees to reflect their own practice Performance indicators are a good way to measure practice because they represent the recruits of performance criteria which have … Number of pages: 15-22 Performance indicators are quantitative tools and are usually expressed as a rate, ratio or percentage. Department of Health . The most commonly used domains in performance frameworks were safety, effectiveness and access. Effective improvements in health care require methods to evaluate professional practice. Our single indicator menu is made up of 3 types of indicator: General practice indicators suitable for use in the QOF; General practice indicators suitable for use outside of the QOF; Clinical Commissioning Group indicators. There appears to be considerable overlap between the definitions of many of the domains such as effectiveness and appropriateness. Manuscript content on this site is licensed under Creative Commons Licenses. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. People performance management is important and doing it well has a big impact on the quality of care that your service provides. Selected countries Across all OECD countries, health care is financed by a mix of public and private spending. Van den Berg, M, Heijink, R, Zwakhals, L. National Institute for Health and Clinical Excellence . I have read and accept the terms and conditions, View permissions information for this article. In doing so, policy makers can come closer to achieving universal coverage - access to appropriate healthcare for all at an affordable cost - the ultimate goal of social health insurance. Methodology National Institute for Health and Clinical Excellence . 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. The Danish do not have a formal framework, but one is currently being developed. Login failed. We’ve assembled a collection of sample Key Performance Indicators for you to use as a starting point when building scorecards. The set of performance indicators provided in this article should help policy makers to monitor the development of social health insurance schemes … Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. The reason is simple—quality of care can be enhanced by incorporating the management concepts of continuous quality improvement (CQI). The progress they have made, and choices taken in selecting and using indicators, might be of value for other health systems in contemplating the development of their indicators or frameworks, or modifying their performance mechanisms. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Social Care Key Performance Indicators - Performance to 30 November 2012 For Period Torbay Torbay exc. Developing indicators for the Commissioning Outcomes Framework (COF): interim process guide. Organisation for Economic Co-operation and Development . The health system performance frameworks for each country were reviewed together with their accompanying online and published documentation. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. NHPA commenced operations in 2012. 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. 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