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Creating and using Performance Indicators in Dutch Hospitals

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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Creating and using Performance Indicators in Dutch Hospitals

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  1. Creating and using Performance Indicators inDutch Hospitals Jan Haeck Dutch Health Supervisory OECD 1

  2. Outcome is pivotal! OECD 2

  3. An indicator is a signal; further investigation is mandatory OECD 3

  4. 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

  5. Selection criteria • Feasibility • Focus on hospital care • Clinical relevance • Frequent manifestation • Obvious and rapid improvement of quality outcome OECD 5

  6. 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

  7. The Set: External Indicators Internal Indicators Clinical Scientific Societies oecd 7

  8. 11% 2004 2003 6% 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

  12. 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. Guidelines 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 PatientSafety indicators; choice because of transparency Health insuranceValue 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

  18. Thank you Oecd 22

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