Information for the Future

Sue Hallwright 29 July 2011

What is our (health system) purpose?

Fewer people become unwellUnw

ell p

eopl

e ge

t bet

ter q

uick

erPeople relapse less often

People with long term conditions

live full lives

Effective policies

Info

rmed

cho

ices

High quality services

Good investment decisions

How can information(about services) help?

Policy-makers

Consu

mer

s

Staff and Managers

Funders

Who needs information?

What do they need to know?

The Counties Manukau Experience

Collaborative annual planning for services

Understanding the whole “system” Improving delivery of services

Improving delivery of servicesCommunity Living Service Benchmarking example

NHI Based Reporting to DHB Linked to DHB information in database Benchmarking Dashboards generated

monthly Quarterly Provider Benchmarking Forum

Improving delivery of services

Why benchmark? To collectively improve our performance*

individual teams types of service

To justify continued investment by demonstrating what works well, for whom, under what circumstances and at what cost.

* IHI Triple Aim: improve health outcomes improve consumer experience Improve value for money

Improving delivery of services

Why benchmark?

To allow providers to identify and tackle issues together

To enable providers to reassure funders that they are proactively measuring and lifting performance

In a time of fiscal constraint this is even more important than it was before

Improving delivery of servicesWhat do we benchmark?

Consumers (who used the service?)

Outcomes(impact of service?) – for a particular consumer group

Services(what was done?) – for a particular consumer group

Quality(how good was it?)

Improving delivery of services

Choosing the 17 reportsInterviewed people about how they would choose a

service: Do people like me get better using this service?

Client groups – diagnosis, gender, ethnicity Outcomes for these client groups?

What range services/treatments will I be likely to access if I use this service?

Service mix Does the service use force?

Rates of compulsory care Will the service help stop me getting sick again?

Relapse prevention How much does the service cost?

cost per hour

Current CLS ReportsConsumers (who used the service?)

Diagnosis and duration of care Age groups – current clients Average number of clients per actual FTE % of current clients seen by gender &

ethnicity compared to DHB population

Outcomes (impact of service?) Change in housing status since

registration – clients current during quarter

Change in housing status – all exited clients

Change in employment status since registration – clients current during quarter

Change in employment status – all exited clients

Services (what was done?) average monthly cost for clients – last

12 months or since registration - current average monthly cost - last 12 months

or since registration – exited clients Percentage of current clients seen in the

last 3 months Average cost per hour – direct delivery

(monthly) Frequency distribution of total direct

delivery time (monthly)

Quality (how good was it?) % of current clients in services >3

months who have used respite or inpatient services in last 3 months

% of current clients in service > 3 months who are currently under CTO

average length of stay – current clients 12 month rolling average length of stay

– exited clients

Sample Report: Relapse (benchmark)

Team A

Sample report: Relapse (Team A over time)

Improving delivery of servicesHow does it work? DHB sends each team

benchmarked dashboard individual dashboard (last 12 months)

Quarterly forum offers an opportunity to To discuss interpretation of reports Provide the context/story behind them Learn from others about good practice Question one another

Improving delivery of servicesHow does it work? Within

organisations: Providers disseminate the reports and Educate staff about them Involve workforce in the change process Build team pride Celebrate change Encourage critical reflective practice

In some instances DHB partners are also included

Improving delivery of servicesWhat do CLS providers think?

Provider feedback about the process is very positive

Provider participants would not choose to stop the benchmarking process, despite the added reporting burden !!!

Improving delivery of servicesWhat next? Extend to other services

Acute services (provider arm and NGO) Community support servicees Residential services

”Locality” DHB and NGO benchmarking?

The future of information: Continually expand the availability of

information for: Consumers Staff Service Managers Funders of Services Organisational Leaders Policy-Makers Governments

The future of information:

Create “learning systems” that Use information Reflect improve and innovate

at all levels Find more ways to hear the voices of

consumers (experience of services)

Thank You