Advanced healthcare systems are moving toward greater efficiency, transparency and accountability, and this trend will continue, particularly in fiscally-constrained environments
There is no single measure that will improve service delivery and patient outcomes, ensure financial sustainability and increase accountability and transparency in a health system
Performance reporting in healthcare will work if properly developed and implemented keeping the following twelve lessons in mind:
Program design
Understand the social, political and economic considerations carefully before setting targets, monitoring performance and reporting on them
Strive for mandatory, system-wide participation
Allow health providers and organisations to drive improvements in a devolved manner, which are patient-centred
Strive for more than just wait-time measures—such measures could include re-admission rates, ward infection rates and in-hospital death rates
Include both public and non-public performance reporting mechanisms
Be mindful of minimising dysfunctional, unintended consequences
Always pilot before rolling out
Data collection and reporting
Strive for continual design, accuracy and relevancy testing of measures and the way data are collected and reported
Ensure data collection is not an end in itself but a driver of positive change within the health system, and avoid onerous data collection and reporting overburden
Real-time reporting should be the goal, which delivers comparative clinical performance data back to health service providers and organisations
Stakeholders
Engage key stakeholders, especially clinicians and senior leadership, but also the media and general public
Change the culture of provider organisations to foster learning over punishing and judging, which also allows clinical staff to raise questions and concern
