Future directions for CHA’s Benchmarking Member Service

PerformanceDashboard 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

CHA Dashboard Indicators Report2010-11

Currently some 60 indicators2011 meeting gave feedback on

improvements. Need to think about improving structure and

adding value:Fit within broader frameworkStart 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

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Aligning performance measurement

Fit within broader frameworkNationalJurisdictional

Ensure relevant to paediatricsInfluence how we deliver careAvoid duplication

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Key QuestionsDo the current indicators reflect Paediatric

priorities? Y/NWhere are the gaps?Collection difficulties eg Infection control, MH

Are the current indicators of value to member Hospitals? Y/NWhat 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?

The approachDivide into groupsEach group will appoint a scribeAll will address the same question – 5 minutesAll move to new table except scribeRepeat process for next questions in

sequenceCollate responsesSummary feedback to group

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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.

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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.

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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 leaveOverlap with other CHA data collections

(benchmarking).

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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.

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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

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Next stepsCirculate to participants for review and

confirmationRefer to Dashboard Indicator Steering Group

for actionBrief CHA Board