Creating and using Performance Indicators in Dutch Hospitals

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Creating and using Performance Indicators
inDutch Hospitals

Jan Haeck Dutch Health Supervisory
OECD 1
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Outcome is pivotal!
OECD 2
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An indicator is a signal further investigation
is mandatory
OECD 3
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Intentions

• Health authority Patientsafety
• Effectiveness
• Appropriateness
• Hospital Accountability Transparency
• Quality-improvement
• Patient Choice
• Quality-assurance
• Healthinsurance Value for money

World Health Care Congress 1
OECD 4
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Selection criteria

• Feasibility
• Focus on hospital care
• Clinical relevance
• Frequent manifestation
• Obvious and rapid improvement of quality outcome

OECD 5
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IMPORTANT CONDITIONS
.All Dutch hospitals participate .All data are
publicly available ....Hospitals present data and
their interpretation on www .... Annualy maximal
25 of the set will be renewed
!
OECD 6
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The Set External Indicators
Internal Indicators
Clinical Scientific Societies
oecd 7
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11
2004
2003
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Annual pressure-ulcer point-prevalence measurement
oecd 8
9
Results Set Performance Indicators Results
specific inspections
Annual meeting with the executive board
Disciplinary measures (if necessary)
oecd 9
10
2003 (78)
Percentage of patients to get surgery after a hip
fracture within 24 hours
2004 (79)
oecd 10
11

Innovations in quality 2003/2004

oecd 11
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Data available about readmissions for
heartfailure within 12 weeks after
discharge (number of hospitals)
oecd 12
13
Data available for standardized pain measurement
within 72 hours postoperative (number of
hospitals)
2004
Recovery room
2003
All hospital wards
oecd 14
14
2003
2004
Oesophagus-cardia resectie
oecd 16
15
2003
oecd 18
16
Conclusions

• Health authority Supervision only in
  risk-bearing hospitals
• Hospital More data improved quality of care
  100 transparent guidelines by
  professionals
• Patient Safety indicators choice because of
  transparency
• Health insurance Value for money (yet to be
  proven)

oecd 20
17
Perverse effects?

• 'gaming the numbers
• Increase in bureaucracy
• An obstacle for innovations and ambitions
• A decrease in solidarity between hospitals

oecd 21
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Thank you
Oecd 22