Dr Mohammed Alahmed http fac ksu edu saalahmed

Dr. Mohammed Alahmed http: //fac. ksu. edu. sa/alahmed Dr. Mohammed Alahmed Performance Measurement and Analysis for Health Organizations alahmed@ksu. edu. sa 1

Introduction • • • To Plan To Comply To Manage To Monitor To Optimize To Innovate Dr. Mohammed Alahmed Why measure ? 2

• It is important to choose only the critical activity(ies) to be measured. • Choosing the area to be measured should be based on the importance of the problem, service-user safety, potential for improvement and controllability by health or social care system/professionals. • To measure and quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality care. • Accurate performance measurement is dependent on information that is of good quality, comparable and can be shared within the health sector Dr. Mohammed Alahmed What to measure? 3

• “Performance” must be defined in relation to explicit goals reflecting the values of various stakeholders (such as patients, professions, insurers, regulators). • Measurement is central to the concept of quality improvement • When performance is measured, there always has to be an entity that is performing. • The entity may be as small as a single clinician or as large as a comprehensive health care system Dr. Mohammed Alahmed What is performance and where is it measured? 4

• Performance measurement is the regular collection of data to assess whether the correct processes are being performed and desired results are being achieved • Performance measurement including: • Selection and use of quantitative measures that provide information about critical aspects of activities, including their effect on patients. Measures of what “actually happened” can be compared to goals set by your organization. • Performance measurement analyzes the success of a work group, program, or organization's efforts by comparing data on what actually happened to what was planned or intended. • Performance measurement asks, “Is progress being made toward desired goals? Are appropriate activities being undertaken to promote achieving those goals? Are there problem areas that need attention? Successful efforts that can serve as a model for others? ” Dr. Mohammed Alahmed What is Performance Measurement? 5

Terminology • Performance Measure • Performance Standard • Standards are one form of performance measure; they are generally objective standards or guidelines that are used to assess performance. • Performance Target • The planned or expected level of performance Dr. Mohammed Alahmed • A specific quantitative representation of a capacity, process, or outcome deemed relevant to the assessment of performance (a generic term that includes standards, targets, indicators) • Performance Indicator • Indicators are another form of performance measure; they are the data or information that is used to assess progress toward a performance standard 6

• Measuring performance can help you understand how well your organization is accomplishing its goal • There are many reasons why an organization should measure performance: 1. Quality Improvement 2. Transparency 3. Accreditation Dr. Mohammed Alahmed Why Measure Performance? 7

• Performance measurement is a process that systematically evaluates whether your efforts are making an impact on the clients you are serving or the problem you are targeting. • Performance measurement promotes accountability to all stakeholders including the public, service users, clinicians and the Government by facilitating informed decision-making and safe, high quality and reliable care through monitoring, analyzing and communicating the degree to which healthcare organizations meet key goals Dr. Mohammed Alahmed • The focus of performance measurement is less on the individual provider and more on the organization as a whole to evaluate whether an adequate structure and correct processes are in place to achieve the org 8

Dr. Mohammed Alahmed • There are other typical circumstances of why an organization may choose to measure its performance, such as: • Distinguish what appears to be happening from what is really happening • Establish a baseline; i. e. , measure before improvements are made • Make decisions based on solid evidence • Demonstrate that changes lead to improvements • Allow performance comparisons across sites • Monitor process changes to ensure improvements are sustained over time • Recognize improved performance 9

Performance Measures Must Be • Clearly defined • Directly related to planning objectives • Relevant to decision makers and stakeholders • Capable of addressing risk and uncertainty Dr. Mohammed Alahmed • Easily understood 10

• How Do We Develop a Performance Measurement Process? 1. Step 1: Evaluate organizational priorities 2. Step 2: Choose performance measures 3. Step 3: Determine a Baseline 4. Step 4: Evaluate Performance 5. Step 5: Report Results 6. Step 6: Develop a plan and make changes to improve performance 7. Step 7: Monitor performance over time Dr. Mohammed Alahmed Performance Measurement Process 11

What are the methods of performance measurement? • Accounts- describe the overall effect of an alternative in a specific area (e. g. cumulative economic impacts) • Metrics- statistical or numerical measure of system performance 1. 2. 3. 4. Process measure quantifies a health care service provided to, on behalf of, or by a patient, that is based on scientific evidence of efficacy or effectiveness. It quantifies a specific system; e. g. , to get a test done or a service performed. Outcome measure quantifies a patient’s health status resulting from health care. In the clinical area, it often measures a patient outcome so it can be compared to a care standard, such as, a patient’s test value. Balancing measure ensures that changes to improve one part of the system are not causing new problems in other parts of the system. It examines another part of the system to ensure that improvements in one area have no unexpected consequences in another. Structure of care measure quantifies a feature of a health care organization (or clinician) relevant to its capacity to provide health care. Dr. Mohammed Alahmed • There are four types of performance measures: 12

• There are several ways of measuring and presenting provider quality, and these are growing in sophistication as more detailed clinical information about patients becomes easily accessible. Three commonly-used methodologies are: • Percent compliance • Actual vs. expected performance • Performance against a benchmark Dr. Mohammed Alahmed Measurement methodologies 13

PERFORMANCE MEASUREMENT MODEL development measurement performance interpretation management How is performance defined? How is performance measured within the hospital sector? How is performance information used within the hospital sector? How do hospitals evaluate their performance measurement systems? • Which are the implications of PM on equity in healthcare? • • Dr. Mohammed Alahmed selection 14

TERM DEFINITION Performance What is done and how well it is done to provide healthcare (JCAHO 2002) Performance The use of both outcomes and process measures to Measurement* understand organizational performance and effect positive Performance Indicator** Markers or signs of things you want to measure but which may not be directly, fully or easily measured (Alberta Government 1998) Performance Measure A quantitative tool, such as rate, ratio or percentage, that provides an indication of an organization's performance in relation to a specified process or outcome (JCAHO 2002) Process Measure A measure focusing on a process that leads to a certain outcome, meaning that a scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome (JCAHO 2002) Outcome Measure Not simply a measure of health, well-being or any other state; rather, it is a change in status confidently attributable to antecedent care (intervention) (Donabedian 1968) Dr. Mohammed Alahmed change to improve care (Nadzam and Nelson 1997) 15

• Are there things about public health that make performance measurement unique or different? • Measuring performance in public services is different from measuring performance in private enterprises in some ways, but not in many! Dr. Mohammed Alahmed Performance Measurement In Public Health 16