Sustaining a Culture of ExcellenceEnterprise Performance MeasurementProjectJudith Nugent, MPAChief, Health Care Information SectionBureau of Health InformaticsDivision of Public HealthWI Department of Health ServicesVoice: (608) 266-2863E-Mail: judith.nugent@wisconsin.gov

Goal of collective enterprise efforts: AccountabilityAre we making a difference?Have we identified the problem correctly and are we having the impact that we intend?How can we improve our services?Are we making the best use of the resources entrusted to us?

Performance Measurement Project

Tools for AccountabilityPerformance measuresProject managementQuality improvement initiatives

Key Criteria for Selecting the Performance MeasuresAlignment with mission and goalsRelated to Governors priorities and national initiatives/prioritiesOutcome orientedSupported by national comparative dataTied to core public expectations of government

Measure DescriptionsTwenty high-level program performance measures chosenOrganized into three categories of measures, affecting multiple departmental agencies:Health care access and qualityUnderlying factors of healthHealth outcomesEach measure focused on a single overarching condition, such as diabetes

Use of AHRQ State SnapshotsState-level measure of diabetes-related hospital admissions among adults age 18 and over used as benchmark for preventing diabetes-related hospitalizations Composite State-level measure of health care quality used to determine overall quality of health care in Wisconsin Annual review of other available Wisconsin Snapshots measures to determine if any are useful for this project

Use of AHRQ State SnapshotsHealth care access and accountabilityDiabetes management = reduce the rate of preventable hospitalizations due to diabetesOverall quality of health care in Wisconsin = continue to rank well in the Agency for Healthcare Research and Quality composite State-level measure of health care quality

Use of AHRQ State Snapshots

Chart1

178225241

174219239

171.8234.1240

175216234

173219244

WI

Midwest

Nation

Year

Admissions per 100,000 population

AHRQ Diabetes-Related Hospital Admissions

Sheet1

AHRQ Diabetes Related Hospital Admission Data:DRAFT

YearWIMidwestNation

2002178225241

2003174219239

2004172234240

2005175216234

2006173219244

2007

2008

Four diabetes complications-related admission measures are combined: Lower

Extremity Amputations, Uncontrolled, Long-Term Complications, and

Short-Term Complications.

Source: Agency for Healthcare Research and Quality, State Snapshots,Focus on Diabetes Outcomes of Care

For conditions excluded in the above see:

http://statesnapshots.ahrq.gov/snaps08/diab_outcome_table.jsp?menuId=26&state=WI

Focus on diabetes, outcomes of care. State snapshots for selected years.

http://statesnapshots.ahrq.gov/snaps08/index.jsp

http://statesnapshots.ahrq.gov/snaps08/diab_outcome_table.jsp?menuId=26&state=WI

Sheet1

WI

Midwest

Nation

Year

Admissions per 100,000 population

AHRQ Diabetes-Related Hospital Admissions

Sheet2

Sheet3

Using the MeasuresBudget discussions and priority settingIT planning to ensure capacity to measure desired outcomesCommunicationsProgram coordination

Goals for the EffortPrevent injury, illness, and spread of diseaseCreate a healthy environment and protect against environmental hazardsPromote and engage healthy behaviors and mental healthRespond to disasters and assist communities in recoveryPromote accessible, high-quality health services

Whats Next?Update annually, using State and national dataPeriodically re-evaluate and reconsider which measures to include

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