Performance assessment A performance assessment framework is a collation of statistics across a...
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![Page 1: Performance assessment A performance assessment framework is a collation of statistics across a district or within a hospital and is far removed from.](https://reader036.fdocuments.in/reader036/viewer/2022062504/5a4d1b6f7f8b9ab0599b4dde/html5/thumbnails/1.jpg)
![Page 2: Performance assessment A performance assessment framework is a collation of statistics across a district or within a hospital and is far removed from.](https://reader036.fdocuments.in/reader036/viewer/2022062504/5a4d1b6f7f8b9ab0599b4dde/html5/thumbnails/2.jpg)
Performance assessmentA performance assessment framework is a
collation of statistics across a district or within a hospital and is far removed from the practice of an individual practitioner
![Page 3: Performance assessment A performance assessment framework is a collation of statistics across a district or within a hospital and is far removed from.](https://reader036.fdocuments.in/reader036/viewer/2022062504/5a4d1b6f7f8b9ab0599b4dde/html5/thumbnails/3.jpg)
Areas of performance monitoringHealth improvementHealth outcomes of health careFair access Effective delivery appropriate careEfficiency Patient /carer experience
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Health improvementThis reflects the general aim of the health
service to improve the health of the population
Many factors beyond the health service influence the health of populations
![Page 5: Performance assessment A performance assessment framework is a collation of statistics across a district or within a hospital and is far removed from.](https://reader036.fdocuments.in/reader036/viewer/2022062504/5a4d1b6f7f8b9ab0599b4dde/html5/thumbnails/5.jpg)
Examples of health improvement indicatorsStandardized all-cause mortality ratio
(stratified by age)Cancer registration ratesDeaths from malignant neoplasmsDeaths from all circulatory diseases <75Deaths from suicideStandardized mortality rate from accidents
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Health outcomes of healthcareThis measures the success of NHS in
reducing risk factors and level of disease, impairment and premature death and improvement in QoL for patients
![Page 7: Performance assessment A performance assessment framework is a collation of statistics across a district or within a hospital and is far removed from.](https://reader036.fdocuments.in/reader036/viewer/2022062504/5a4d1b6f7f8b9ab0599b4dde/html5/thumbnails/7.jpg)
Examples of health outcome indicators• Emergency admission in patients over 75 Y• Emergency psychiatric readmission• Infant mortality• 5 year survival rates (for cancers)• Avoidable mortality• Hospital deaths after surgery or heart attacks• Complications of treatments/ 28 day
emergency readmission rate
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Fair access This measures the fairness of service
provision in relation to need, geography, socio-economic status, age, sex and ethnicity
![Page 9: Performance assessment A performance assessment framework is a collation of statistics across a district or within a hospital and is far removed from.](https://reader036.fdocuments.in/reader036/viewer/2022062504/5a4d1b6f7f8b9ab0599b4dde/html5/thumbnails/9.jpg)
ExamplesInpatient waiting lists to reflect variations in
the supply and demand for servicesRegistration of adults and children with
dentistsEarly detection of cancerDisease prevention(% of children immunized
in a district
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Effective delivery of appropriate careThis is a measure of the extent to which local
services are clinically effective, appropriate to local health needs, timely and in line with evidence based standards
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Examples Discharge from hospital within 65D after
emergency admission for stroke and 28D after fractured neck femur
Inappropriately used surgerySurgery rates- age standardized elective
rates for CABG total hip or knee replacement, cataract replacement
Early detection of cancer
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Efficiency This measures the extent to which the NHS
provides efficient services, including cost per unit of care or outcome
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Examples Case mix adjusted length of stayUnit cost of maternity serviceUnit cost of specialist mental health servicePercentage of generic prescribing
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Patient/ carer experienceThe perception of responsiveness to
individual needs and preferencesThe continuity of service provisionPatient involvementGood information and choiceWaiting and accessibility
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Clinical indicators“health outcome” and “health improvement”
indicators are influenced by many more factors than simply clinical care
It will be useful to gauge the quality of local health services
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Examples of clinical indicators• Deaths in hospital within 30 days of surgery:
emergency and non emergency admission• Deaths in hospital within 30 days of emergency
admission with a hip fracture for patients 65Y and over
• Deaths in hospital within 30 days of emergency admission with a heart attack in patients with 50Y and over
• Emergency readmission to hospital within 28 day of discharge from hospital
• Discharge to usual place of residence within 56D of emergency admission from there with a stroke for patients aged 50 and over
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Thank you