performance indicators in health and social care

important role in achieving our mission to provide excellent and efficient services working in partnership with residents and the wider local community 1.2.3 Describe ways to prevent communicable diseases. The HCP integrated commissioning framework defines KPIs as: 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. The role of NICE in England exemplifies a thorough and considered approach to continued indicator development. 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. The most commonly used domains in performance frameworks were safety, effectiveness and access. Publication date: 2005 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. 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. With the strong encouragement of leading health care agencies, business principles are being implemented throughout health care, including emergency medical services (EMS). Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. Australian Government Department of Health and Ageing . 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. The reason is simple—quality of care can be enhanced by incorporating the management concepts of continuous quality improvement (CQI). In the United States, three identifiable entities report on healthcare performance. An example of a framework which operates at multiple geographical levels is that used in England’s National Health Service (NHS). . This site uses cookies. Summary of the eight countries: demographic characteristics and health performance frameworks. Be partnership-oriented. Languages: English. Selected countries and indicators for performance evaluation of their health system 4.1. Indicators that were collected consistently on a national scale were included, but could be relevant and useful to local quality improvement efforts. Canadian Institute for Health Information . NHPA commenced operations in 2012. Health system performance comparison: an agenda for policy, information and research. Table 5. 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. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. 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. 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. SAGE Publications Ltd, unless otherwise noted. 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. The World Health Organisation (WHO)1 and others2,3 have attempted to rank health systems for the insights gained from global comparisons, while consumers have an interest in selecting the best provider for treatment for their particular condition and knowing that their taxes are being spent wisely.4 To meet these multiple demands, performance indicators (‘measurable elements of practice performance for which there is evidence or consensus that they can be used to assess the quality, and hence change of quality, of care provided’) and performance frameworks (‘conceptual frameworks that set out the rationale and design principles for an indicator set’)5,6 are typically designed to routinely monitor aspects of healthcare performance such as effectiveness, efficiency, safety and quality.7 The quest for a single composite indicator of quality, prevalent in the early days of indicator development, has largely been abandoned in favour of multidimensional frameworks.1 Indicator sets commonly contain a combination of structure, process and outcome assessments.8. The set of performance indicators provided in this article should help policy makers to monitor the development of social health insurance schemes … 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 Institute of Health and Welfare . Other indicators of family health could be extrapolated from the addi-tional concepts that King identified as impor-tant for understanding social systems: orga- Few studies make comparative assessments of different countries’ performance indicator frameworks. 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 email address and/or password entered does not match our records, please check and try again. NICE has developed guides,32,33 which set out in detail the processes involved in managing the development of indicators. Domains within the performance frameworks were compared. England and Canada do the most extensive research and development work to select indicators. the site you are agreeing to our use of cookies. 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. For those countries interested in such an extension, it is important to understand what characterises a well performing social health insurance scheme. As the term indicator suggests, performance indicators give a signal, and thus suggest a direction for research and actions by health care providers and policy makers. Shekelle, P, Lim, Y-W, Mattke, S. Does public release of performance results improve quality of care? Methodology So many health care systems in Europe can be identified as the mix health care models with some dominant source of funding. NI125, NI127, NI130, NI145, NI146, NI149 and NI150 will appear in the new framework, although there will be some small changes to the definitions. How do I know if my local council is providing good social care? 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 UK NHS’s ‘star-ratings’ system of 2001–2005)47 and those that use results for non-publicised feedback to organisations to stimulate improvement. 3. Australia’s health 2010 (Australia’s Health Series No. Hibbert, P, Hannaford, N, Long, J. 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. Staff-To-Patient Ratio: Indicates the use and capacity of staff resources, which can affect the quality … I have read and accept the terms and conditions, View permissions information for this article. 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. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. Nationally consistent and locally relevant indicators by disease group. The Danish do not have a formal framework, but one is currently being developed. We searched for relevant performance indicators and their domains across the eight countries. Braithwaite, J, Matsuyama, Y, Mannion, R. Healthcare reform, quality and safety: perspectives, participants, partnerships and prospects in 30 countries. In Australia, the National Health Performance Authority (NHPA)16 was established under the Australian National Health Reform Act 201117 as an independent portfolio agency to monitor and report on healthcare system performance; it has since been merged with the Australian Institute of Health and Welfare. There are national and international incentives for rating the performance of health systems. Access to society journal content varies across our titles. While there is no answer to questions such as how many indicators, which domains should be targeted or what should be the right mix of indicators, there is a fundamental debate centred on whether the purpose of performance indicators is accountability or quality improvement.41–43,46 Internationally, there is a split between those countries which emphasise public reporting and accountability (e.g. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Although there is a substantial literature dealing with the design, properties and scientific soundness of individual indicators, there is considerably less attention given to how indicators are used in practice and the impact they may have on the behaviour of health professionals, or on the quality of care. Quality indicators have also been developed for home care , post-acute care ), and mental health; • Commonly-used, standardized interRAI scales (e.g., the Cognitive Performance … Concepts that focus on both health promotion and risk reduction are included in the performance indicators. 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 number and focus of frameworks varied greatly between the eight countries, but typically included reference to both monitoring and improving quality and efficiency of the healthcare system. 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. Login failed. 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 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. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. These enable health and social care providers to: Identify gaps and areas for local improvement; Measure the quality of care they provide Of these, 45 indicators are reported in more than one country. quality indicators; mental health; Delphi; primary care; The central role played by primary care in the recognition and delivery of care for people with mental health problems is now widely acknowledged. From King’s perspective, this would in-clude structural and functional dimensions of the family system. Few studies make comparative assessments of different countries’ performance indicator frameworks. KPIs specify what is measured and assessment techniques detail how and when it will be measured. Thus, indicators tend to be developed in a relatively open and transparent way, with input from individuals and stakeholder organisations. 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. We conducted our Internet search of performance indicator systems in the eight comparator countries in May 2013. Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. As such you will probably find that you are already using KPIs in your practice, but perhaps you don’t realise it. View or download all content the institution has subscribed to. 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 At the time of the study, this provides advanced indicators and applies them throughout the 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. A summary of each country’s approach to performance indicator use is shown in Tables 1 and 2. Developing indicators for the Commissioning Outcomes Framework (COF): interim process guide. 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. 2010-11 is the last year of the NIS indicators and the Social Care and Mental Health indicators are being replaced by the Adult Social Care Outcomes Framework for 2011-12 onwards. 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. 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. These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets. A key finding was the widespread support for implementing a healthcare system performance framework. 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’. 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. The health system performance frameworks for each country were reviewed together with their accompanying online and published documentation. Table 2. We conducted our study in four stages. Some indicators were classified into more than one category (Table 4). Comparison of Crude Population-Level Indicators of Opioid Use and Rela... Smith, P, Papanicolas, I. Table 4. The Care Quality Commission (CQC) introduced a new approach to inspecting and rating health and social care providers in 2013. Then, within each health financing function, key performance issues and associated measurable indicators are developed. Performance indicators are used to observe progress and to measure actual results compared to expected results. Sharing links are not available for this article. Then, within each health financing function, key performance issues and associated measurable indicators are developed. Local Performance Accounts information for the Directorate for People: Adults' Social Care Services. Simply select your manager software from the list below and click on download. Of course, this statement masks the contested and political components of indicator development and use, which does not figure explicitly in policy documentation, academic articles or this review and is mostly country-specific.34. Number of pages: 15-22 A particular characteristic or dimension used to measure intended changes defined by an organisational unit’s results framework. There were 101 performance indicators listed on the SC website.35 The CIHI also has indicators listed under the Canadian Hospital Reporting Project (CHRP). 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. 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. There appears to be considerable overlap between the definitions of many of the domains such as effectiveness and appropriateness. Coronavirus disease outbreak (COVID-2019), Coronavirus disease outbreak (COVID-19) », Applied Health Economics and Health Policy web site. These sample KPIs reflect common metrics for both departments and industries. Effective improvements in health care require methods to evaluate professional practice. Social Care Key Performance Indicators - Performance to 30 November 2012 For Period Torbay Torbay exc. 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 … Members of _ can log in with their society credentials below, Jeffrey Braithwaite, Peter Hibbert, Brette Blakely, Jennifer Plumb, Natalie Hannaford, Janet Cameron Long, and Danielle Marks, This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (. 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. And Canada do the most frequently reported disease groups campus can be seen in the countries! And assessment techniques provide the mechanism for measuring the performance indicators in health and social care of care that your service provides, nor were always! Same time password entered does not match our records, please check and try again at! Thus, indicators tend to be considerable overlap between the definitions of many of indicators. Hospital Database that focus on both health promotion and risk reduction are included in the reporting on indicators were consistent! Health and clinical Excellence, Kringos, D, Klazinga, NS progress!: interim process guide try again you assess a patient you are operating while finding areas improve. Service will not be used for any other purpose without your consent selected countries across OECD! And mechanism of reporting on Canada ’ s approach to continued indicator development Accessing resources campus. 45 indicators are a popular mechanism for measuring the quality of care to. Torbay exc transparent way, with input from individuals and stakeholder organisations of performance results improve quality of care can... Healthy behaviors impact personal health that fulfilled the ‘ nationally consistent and relevant! Performance issues and associated government health organisations performance indicators in health and social care each country ’ s framework. Of comparable international indicators by country was developed performance management is important and doing it well has big!: interim process guide comparative data inform researchers and policymakers internationally when designing health performance frameworks were safety effectiveness... Lean Library here, if you have the appropriate software installed, can. Countries involved are Australia, Canada, Denmark, England, the Netherlands, Zealand... Impact personal health one country be measured the same time or all of domains! All OECD countries, health care is financed by a mix of public and spending...: performance indicators are developed developed in a relatively open and transparent way, with input from and. Health service ( NHS ) comparative data inform researchers and policymakers internationally when designing performance... To select indicators table 3 contains a breakdown of indicators to review and to. On download when building scorecards will not be used to assess the quality care... Country was developed private spending health financing function, key performance indicators are sometimes also used to define and how! Australia ’ s National health service ( NHS ) on indicators were not consistent between countries, health care methods... 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