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Creating and using Performance Indicators in Dutch Hospitals. Jan Haeck Dutch Health Supervisory. OECD 1. Outcome is pivotal!. OECD 2. An indicator is a signal; further investigation is mandatory. OECD 3. Intentions. Health authority Patientsafety Effectiveness

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Presentation Transcript
intentions
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

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

OECD 5

slide6

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

slide7

The Set: External Indicators

Internal Indicators

Clinical Scientific Societies

oecd 7

slide8

11%

2004

2003

6%

Annual pressure-ulcer point-prevalence measurement

oecd 8

slide9

Results Set Performance

Indicators

+

Results specific inspections

Annual meeting with the executive board

Disciplinary measures

(if necessary)

oecd 9

slide10

2003 (78%)

Percentage of patients to get surgery after a hip fracture within 24 hours

2004 (79%)

oecd 10

slide11

Innovations in quality

2003/2004

oecd 11

slide12

Data available about readmissions for heartfailure within 12 weeks after discharge

(number of hospitals)

oecd 12

slide13

Data available for standardized pain measurement within 72 hours postoperative

(number of hospitals)

2004

Recovery room

2003

All hospital wards

oecd 14

slide14

Guidelines

2003

2004

Oesophagus-cardia resectie

oecd 16

slide15

2003

oecd 18

conclusions
Conclusions

Health authority Supervision only in risk-bearing hospitals

Hospital More data; improved quality of care; 100% transparent; guidelines by professionals

PatientSafety indicators; choice because of transparency

Health insuranceValue for money (yet to be proven)

oecd 20

perverse effects
Perverse effects?
  • 'gaming the numbers‘
  • Increase in bureaucracy:
  • An obstacle for innovations and ambitions
  • A decrease in solidarity between hospitals

oecd 21

slide18

Thank you

Oecd 22