Future directions for CHA’s Benchmarking Member Service

1. Future directions for CHA’s Benchmarking Member Service

2. Performance • Dashboard indicators being collected consistently across CHA although still gaps. • Performance needs to be analysed within the appropriate context. • Hospitals treat patients with different casemix and severity which can impact outcomes. • To make meaningful and fair comparisons, future studies need to allow for risk-adjustment including age, sex, co-morbidity and socio-economic status or the need for transfers • Many outcome indicators more meaningful when measured at the clinical procedure or condition level, rather than the hospital wide level. • Better to compare ‘like’ patient groups with similar risks and outcomes

3. CHA Dashboard Indicators Report2010-11 • Currently some 60 indicators • 2011 meeting gave feedback on improvements. • Need to think about improving structure and adding value: • Fit within broader framework • Start to report trends by year (control charts) • Would be helpful to map to existing collections so that can see overlap eg Performance agreements, Accreditation, other

4. Aligning performance measurement • Fit within broader framework • National • Jurisdictional • Ensure relevant to paediatrics • Influence how we deliver care • Avoid duplication

5. Key Questions • Do the current indicators reflect Paediatric priorities? Y/N • Where are the gaps? • Collection difficulties eg Infection control, MH • Are the current indicators of value to member Hospitals? Y/N • What can be done to improve their utility? • Large vs Small hospitals • Other indicators eg HR • How can the dashboard indicator program be improved? How could presentation of the data be improved?

6. The approach • Divide into groups • Each group will appoint a scribe • All will address the same question – 5 minutes • All move to new table except scribe • Repeat process for next questions in sequence • Collate responses • Summary feedback to group

7. Feedback Question 1Do the current indicators reflect Paediatric priorities? • Indicators do not necessarily reflect agreed paediatric priorities. • Driven by performance frameworks in each state, national, ACHS and quality and safety. • Not always relevant to paediatrics. • Many other important collections by craft groups not reflected. • Currently collect too many indicators yet have emerging gaps in areas such as new health reforms, ambulatory/ outpatients care, mental health, immunisation, obesity, diabetes and respite care.

8. Feedback Question 2 Are the current indicators of value to member Hospitals? • Developing a better understanding with each collection. • Data set becoming increasingly dependable and provides basic reassurance but still patchy. • Helpful to know hospitals are comparing like with like but concern raised that members do not necessarily apply consistent criteria. • Some indicators lack clarity. Tending to be more administrative than clinical. Will need to strike a balance.

9. Detail insufficient for more comprehensive comparative or advocacy purposes. • Burden for smaller hospitals who would get value out of a smaller dataset. • Feedback needs to be timely to be of value. • Other new measures – as per Q1, Sick leave • Overlap with other CHA data collections (benchmarking).

10. Feedback Question 3How can the dashboard indicator program be improved? • Agree paediatric priority areas and indicator set to monitor. • Consider a single annual collection with consolidation of CHA databases to reduce duplication of effort and facilitate integrated reporting. • Reduce to a relevant KPI set for paediatrics that address agreed existing and emerging priorities. • Use as an opportunity to influence measures in other collections.

11. Foster clinician leadership and engagement at each hospital and encourage clinician feedback on relevant data and performance measures eg. Diabetes. • Redefine the size of facilities into realistic groups for both data collections and reporting • Enhance reporting to flag trends and significant changes and report selectively at a specialty level. • Learn from innovation at other sites- Relate clinical models to indicators and benchmark data - Relate to other indicators (specialty) • Improve consistency, timeliness and process of collections at sites. • Increase skill base in hospitals in information management

12. Next steps • Circulate to participants for review and confirmation • Refer to Dashboard Indicator Steering Group for action • Brief CHA Board