Just Watch The Bureaucrats Game This System – Reliable National Hospital Performance Monitoring Will Not be Easy.

There is a key platform of the new Health Reform Plan that relies on much improved measurement of the performance of Public Hospitals all around the country.

National monitor of how hospitals stand out or fail

MARK METHERELL HEALTH CORRESPONDENT

April 22, 2010

AUSTRALIANS should soon be able to find out how the nation's hospitals compare in terms of quality and safety measures such as the incidence of bungled treatment and introduced infections.

State and federal health officials are expected next week to decide on hospital performance measures, although the timing of their publication will be up to individual states.

The measures to be published are expected to include the rate of ''adverse events'' such as treatment mistakes, unexpected re-admissions, possibly resulting from substandard surgery, and delays in access to hospital emergency departments, general practitioners and dental care.

The development of greater consumer awareness comes as the government foreshadows a shake-up in the heavily regulated aged-care sector, having announced a wide-ranging inquiry by the Productivity Commission.

On the hospital reporting issue, a spokeswoman for the federal Health Minister, Nicola Roxon, said yesterday the first report on a national healthcare agreement would be considered next week. ''It will then be released publicly as soon as possible following endorsement from all [state] jurisdictions.''

Under the reforms agreed to this week, each of the proposed 100 local hospital networks, individual hospitals including private hospitals and the proposed primary healthcare organisations will have important aspects of their performance measured and published.

But while high performers will be held up as examples, secret reports will be lodged with national and state authorities on poor performers under the Council of Australian Governments' agreement on the national health and hospitals network.

A new National Performance Authority will provide ''clear and transparent quarterly public reporting'' on the performance of every hospital and primary care organisation, as the text of the agreement between the Prime Minister and the premiers states.

More here:

http://www.smh.com.au/national/national-monitor-of-how-hospitals-stand-out-or-fail-20100421-t0mi.html

The proposal here is to permit those who are failing to do so in secret. The quality of this farce will only be missed by the senior health bureaucrats. The rest of us will merely emit a pathetic and frustrated – “they are doing what?!!!!!”

All this reminds one of the good old days when the size of public hospital waiting lists – which were always hopeless gamed and inaccurate – used to shrink just before elections and then grow dramatically just after – to progressively decrease as the next election approached.

Only audited data obtained from live operational systems that clinicians actually use to deliver care, and so are concerned about information accuracy, should be used to monitor hospital performance. Having ward clerks and administrators gather data manually and then report it just puts too much temptation in the way of such administrators to ‘adjust the figures’.

See here for the gory details from Victoria last year!

http://aushealthit.blogspot.com/2009/04/lies-damned-lies-statistics-and.html

Sadly we have neither the systems nor the resolve it would seem to do information gathering properly. Just watch how it plays out and just how dodgy the Key Performance Indicators that are used to measure Hospital Performance turn out to be!

What a shame!

David.

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