Divisions Performance Indicators

1

• Divisions Performance Indicators
• How Will It Work?
• Beverly Sibthorpe
• Deputy Director
• Australian Primary Health Care Research Institute

2
Overview of Presentation

• Indicator development
• Technical details
• Types of data data sources
• Qualitative quantitative indicators
• Information systems for Level 3/4 reporting
• Collation, analysis and interpretation
• Quality assurance
• Equity

3
Divisions Performance Indicators

• Governance and Program
• Different processes common framework
• Governance
• Organisational structures and processes (Level 1)
• Program
• Organisational structures and processes,
  processes of care for patients, intermediate
  outcomes for patients (Level 1 Level 4)
• Endorsed by the RIC

4
Indicator Development Governance

• Working group
• 2-day workshop facilitated by Elizabeth Jameson,
  Board Matters Pty Ltd (Divisions network,
  Department, other stakeholders)
• All compulsory progress 2005-2008
• Goal is accreditation
• Accreditation greatly reduced reporting 9
  2

5
Indicator Development Program
6
Indicator Development Program

• Guideline evidence-based
• Support Government policies/programs
• Two rounds of consultation
• National/international expert review
• 100 pages of feedback
• Collated, reviewed, incorporated into final
  version

7
Technical Details

• Rationale
• Type of indicator
• Data required
• How data will be obtained
• Data coding
• How to calculate the measure
• How to report the result
• Data quality assurance processes
• Characteristics of Divisions for comparisons

8
Information Sources - Levels 1 2

• Information generated by the Division N_RES 1.1
• Information from GPs (GP survey) N_INT 2.2
• Information from practices (practice survey, /-
  practice visits, email or telephone contact)
  N_DIA 2.1 N_MNH 2.2 N_ASM 2.1
• Data about practices provided to the Division
  from other source N_IMM 2.2

9
Information Sources - Levels 3 4

• Summary information from GPs/practices about
  processes of care for patients - N_ASM 3.1
• Summary information about processes of care for
  patients from other source N_MNH 3.1
• Summary information from GPs/practices about
  outcomes for patients N_DIA 4.2
• Supplementary information provided to Division
  from other sources aged care beds, diabetes
  prevalence, demand for 3-step mental health
  plans

10
Information about Patients

• 9/52 require information about patients
• 5 compulsory all information from other sources
• Participate in Level 3 Level 4 without full
  computerisation or electronic data transfer
• Information
• - summary table based on patient records or
• - extracts of patient records transferred
  electronically
• Both methods in same Division
• Division collates all data to produce summary
  table

11
Data from other Sources

• Dont have to collect all information
• Provided to Division
• ACIR, DoHA, HIC
• Estimates from health survey and other data
• User-friendly, timely, consistent
• Coordinated nationally

12
Reporting

• Mechanism for reporting defined for every
  indicator
• Qualitative descriptive data - text in defined
  format
• Quantitative numerical data - table provided
• Explanatory text
• Additional questions
• data source for data Quality Assurance
• completeness of capture of ATSI origin

13
Example 1 Qualitative data

• N_IMM 1.1 Division collaborates with other
  organisations, service providers and
  consumer/carer groups to promote and support
  quality immunisation practices.

14
Example 1 Qualitative data
15
Example 2 Quantitative data

• N_DIA 4.1 Number and proportion of patients with
  diabetes on the practice register/recall system
  whose most recent HbA1c in the past 12 months
  was
• - 7.0 or less
• - more than 7 but less than 10.0
• - 10.0 or more
• - not measured.

16
Example 2 Quantitative data
17
Example 2 Quantitative data
18
Information System to Support Electronic Level
3/4 Reporting

• Choose to participate 2005-2008
• Off-the-shelf information system to support GPs/
  practices
• Build on existing systems capacity
• Value-adding through national analysis,
  interpretation and feedback to Divisions
• IM/IT development and support for participating
  practices and Divisions

19
Analysis, Interpretation Feedback

• Information Flows
• Timely flows of meaningful and useful information
  (Divisions, GPs, consumers, DoHA, other
  stakeholders)
• Reports of achievement provided to DoHA 6 month
  and annual reports
• Nationally consistent analysis and interpretation
• Appropriate feedback mechanisms
• Access to other population health data

20
Equity

• Differences between Divisions
• Comparisons take differences into consideration
• -  state, geographic size, number of GPs,
  income,
• Index of Relative Social Disadvantage,
  proportion
• of population Aboriginal/Torres Strait
  Islander
• Differences among patients
• Reporting on sub-populations limited by summary
  data
• -   age, sex, Aboriginal and Torres Strait
  Islander
• origin, language spoken at home

21
Data Quality Assurance

• System depends on high quality data
• Trusted by all stakeholders (Divisions network,
  consumers, DoHA)
• Methods to be developed

22
System Under Development

• Validity of performance of indicators assessed
• Targets developed
• Characteristics of Divisions for comparisons
  (e.g. rurality) refined
• Other data requirements reviewed
• Approaches to analysis and interpretation refined
• Mechanisms for feedback to Divisions (e.g. web
  based) developed, tested and refined