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Nabovati E, Farrahi R, Sadeqi Jabali M, Khajouei R, Abbasi R. Identifying and prioritizing the key performance indicators for hospital management dashboard at a national level: Viewpoint of hospital managers. Health Informatics J 2023; 29:14604582231221139. [PMID: 38062641 DOI: 10.1177/14604582231221139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Participation of main users in identifying key performance indicators (KPIs) for management dashboards contributes to their success. The aim of this study was to identify and prioritize the KPIs of hospital management dashboards from the viewpoint of hospital managers. This study was conducted on managers of public hospitals at a national level in Iran in 2020. Data were collected using a self-administrated questionnaire. The KPIs were classified into five categories, namely financial, operational, human resources, safety and quality of care, services provided to patients. A total of 234 hospital managers participated in this study. Totally, 25 KPIs were determined for the hospital management dashboard, including the patient falls rate, waiting time for patients in the emergency department, patient satisfaction, total hospital revenue, financial balance, bed occupancy rate, patients' discharge with own agreement, average length of stay, and personnel satisfaction. For designing hospital management dashboards, the domains of services provided to patients, safety and quality of care, financial resources, human resources, and operational are important from the hospital managers' viewpoint, respectively. The results of this study can be helpful for developers of business intelligence tools, such as hospital management dashboards, to visualize the most important indicators for managers.
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Affiliation(s)
- Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran
| | - Razieh Farrahi
- Department of Health Information Technology, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran
- Department of Management and Health Information Technology, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Monireh Sadeqi Jabali
- Department of Health Information Technology, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran
- Department of Management and Health Information Technology, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Khajouei
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Abbasi
- Department of Health Information Technology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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Salet N, Stangenberger VA, Bremmer RH, Eijkenaar F. Between-Hospital and Between-Physician Variation in Outcomes and Costs in High- and Low-Complex Surgery: A Nationwide Multilevel Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:536-546. [PMID: 36436789 DOI: 10.1016/j.jval.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Clinicians and policy makers are increasingly exploring strategies to reduce unwarranted variation in outcomes and costs. Adequately accounting for case mix and better insight into the levels at which variation exists is crucial for such strategies. This nationwide study investigates variation in surgical outcomes and costs at the level of hospitals and individual physicians and evaluates whether these can be reliably compared on performance. METHODS Variation was analyzed using 92 330 patient records collected from 62 Dutch hospitals who underwent surgery for colorectal cancer (n = 6640), urinary bladder cancer (n = 14 030), myocardial infarction (n = 31 870), or knee osteoarthritis (n = 39 790) in the period 2018 to 2019. Multilevel regression modeling with and without case-mix adjustment was used to partition variation in between-hospital and between-physician components for in-hospital mortality, intensive care unit admission, length of stay, 30-day readmission, 30-day reintervention, and in-hospital costs. Reliability was calculated for each treatment-outcome combination at both levels. RESULTS Across outcomes, hospital-level variation relative to total variation ranged between ≤ 1% and 15%, and given the high caseloads, this typically yielded high reliability (> 0.9). In contrast, physician-level variation components were typically ≤ 1%, with limited opportunities to make reliable comparisons. The impact of case-mix adjustment was limited, but nonnegligible. CONCLUSIONS It is not typically possible to make reliable comparisons among physicians due to limited partitioned variation and low caseloads. Nevertheless, for hospitals, the opposite often holds. Although variation-reduction efforts directed at hospitals are thus more likely to be successful, this should be approached cautiously, partly because level-specific variation and the impact of case mix vary considerably across treatments and outcomes.
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Affiliation(s)
- Nèwel Salet
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Zuid-Holland, The Netherlands; Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Zuid-Holland, The Netherlands.
| | - Vincent A Stangenberger
- Amsterdam University Medical Center, University of Amsterdam, Noord-Holland, The Netherlands; LOGEX b.v., Amsterdam, Noord-Holland, The Netherlands
| | | | - Frank Eijkenaar
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Zuid-Holland, The Netherlands
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Vaandering A, Jansen N, Weltens C, Moretti L, Stellamans K, Vanhoutte F, Scalliet P, Remouchamps V, Lievens Y. Radiotherapy-specific quality indicators at national level: How to make it happen. Radiother Oncol 2023; 178:109433. [PMID: 36464181 DOI: 10.1016/j.radonc.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE /OBJECTIVE To promote best practice and quality of care, the Belgian College of Physicians for Radiotherapy Centers established a set of radiotherapy specific quality indicators for benchmarking on a national level. This paper describes the development, the collected QIs, the observed trends and the departments' evaluation of this initiative. MATERIAL AND METHODS The Donabedian approach was used, focussing on structural, process and outcome QIs. The criteria for QI selection were availability, required for low-threshold regular collection, and applicability to guidelines and good practice. The QIs were collected yearly and individualized reports were sent out to all RT departments. In 2021, a national survey was held to evaluate the ease of data collection and submission, and the perceived importance and validity of the collected QIs. RESULTS 18 structural QI and 37 process and outcome parameters (n = 25 patients/pathology/department) were collected. The participation rate amounted to 95 % overall. The analysis gave a national overview of RT activity, resources, clinical practice and reported acute toxicities. The individualized reports allowed departments to benchmark their performance. The 2021 survey indicated that the QIs were overall easy to collect, relevant and reliable. The collection of acute recorded toxicities was deemed a weak point due to inter-observer variabilities and lack of follow-up time. CONCLUSION QI collection on a national level is a valuable process in steering quality improvement initiatives. The feasibility and relevance was demonstrated with a high level of participation. The national initiative will continue to evolve as a quality monitoring and improvement tool.
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Affiliation(s)
- Aude Vaandering
- UCL Cliniques Universitaires St Luc, Department of radiation oncology, Brussels, Belgium; Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
| | - Nicolas Jansen
- University Hospital of Liège, Department of radiation oncology, Liège, Belgium
| | - Caroline Weltens
- Department of Radiation Oncology, University Hospitals Leuven, KU Leuven, Belgium
| | - Luigi Moretti
- Institut Jules Bordet, Department of radiation oncology, Brussels, Belgium
| | - Karin Stellamans
- AZ Groeninge, Department of radiation oncology, Kortrijk, Belgium
| | - Frederik Vanhoutte
- Ghent University Hospital and Ghent University, Department of radiation oncology, Ghent, Belgium
| | - Pierre Scalliet
- Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Vincent Remouchamps
- CHU-UCL Namur - site Saint Elisabeth, Department of radiation oncology, Namur, Belgium
| | - Yolande Lievens
- Ghent University Hospital and Ghent University, Department of radiation oncology, Ghent, Belgium
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Chmiel E, Pase M, Evans M, Johnson M, Millar J, Papa N. Development of binational radiation therapy quality indicator reports for prostate cancer treatment using registry data. J Med Imaging Radiat Oncol 2022; 66:1097-1105. [PMID: 36251627 DOI: 10.1111/1754-9485.13481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/26/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Quality indicators (QIs) are metrics which seek to allow comparison of clinicians' and institutes' practice to best evidence-based practice. The Australia and New Zealand Prostate Cancer Outcomes Registry (PCOR-ANZ) is a bi-national clinical quality registry with coverage estimated to be over 60% of the men newly diagnosed with prostate cancer. We outline the production and ambition of institute-level QI reports to benchmark performance for radiation therapy in the treatment of prostate cancer. METHODS An expert clinician panel was assembled to create a list of candidate QIs based on a comprehensive literature review, and on modified Delphi-method and expert-consensus voting. A separate implementation group-including, clinicians, epidemiologists, data managers and data scientists-employed an evidence- and consensus- based approach to generate an effective QI report designed for automated production and regular distribution to participating institutes. Feedback from the recipient clinicians was sought to enable refinement of these reports. RESULTS Seven QIs, including three related to post-treatment symptoms, were deemed feasible to analyse with the currently available data. Utilising an existing report template employed for benchmarking of surgical indicators, a novel radiation therapy report was generated using registry data in a secure analytical environment. The first, beta version of these reports have been produced and confidentially distributed. It is planned to automatically generate these reports biannually and iteratively refine them based on the clinician input. CONCLUSION QI reports for the treatment of prostate cancer by radiation oncologists have been produced using data from Australia and New Zealand patients. These are being disseminated to institutes on a six-monthly basis allowing comparisons to de-identified peers. The reports aim to facilitate improving patient outcomes, deepen engagement with the radiation oncology community and increase the breadth of PCOR-ANZ coverage. Additional QIs will be included in future iterations of these reports as data matures.
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Affiliation(s)
| | - Marie Pase
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Melanie Evans
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Maggie Johnson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Nathan Papa
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Di Maio M, Basch E, Denis F, Fallowfield LJ, Ganz PA, Howell D, Kowalski C, Perrone F, Stover AM, Sundaresan P, Warrington L, Zhang L, Apostolidis K, Freeman-Daily J, Ripamonti CI, Santini D. The role of patient-reported outcome measures in the continuum of cancer clinical care: ESMO Clinical Practice Guideline. Ann Oncol 2022; 33:878-892. [PMID: 35462007 DOI: 10.1016/j.annonc.2022.04.007] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/05/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- M Di Maio
- Department of Oncology, University of Turin, at A.O. Ordine Mauriziano Hospital, Turin, Italy
| | - E Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA
| | - F Denis
- Institut Inter-régional de Cancérologie Jean Bernard (ELSAN), Le Mans, France; Faculté de Santé, Université de Paris, Paris, France
| | - L J Fallowfield
- Sussex Health Outcomes Research & Education in Cancer, Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, UK
| | - P A Ganz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), USA
| | - D Howell
- Department of Supportive Care, Princess Margaret Cancer Centre Research Institute, Toronto, Ontario, Canada
| | - C Kowalski
- Department of Certification - Health Services Research, German Cancer Society, Berlin, Germany
| | - F Perrone
- Clinical Trial Unit, National Cancer Institute IRCCS G. Pascale Foundation, Naples, Italy
| | - A M Stover
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA; Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - P Sundaresan
- Sydney West Radiation Oncology Network, Westmead Hospital, Westmead, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia
| | - L Warrington
- Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, UK
| | - L Zhang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - K Apostolidis
- European Cancer Patient Coalition, Brussels, Belgium
| | | | - C I Ripamonti
- Oncology - Supportive Care in Cancer Unit, Department Oncology-Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Milan, Italy
| | - D Santini
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
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Harden SV, Chiew KL, Millar J, Vinod SK. Quality indicators for radiation oncology. J Med Imaging Radiat Oncol 2022; 66:249-257. [PMID: 35243788 PMCID: PMC9310822 DOI: 10.1111/1754-9485.13373] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/05/2021] [Indexed: 11/27/2022]
Abstract
Quality Indicators, based on clinical practice guidelines, have been used in medicine and within oncology to measure quality of care for over twenty years. However, radiation oncology quality indicators are sparse. This article describes the background to the development of current national and international, general and tumour site‐specific radiation oncology quality indicators in use. We explore challenges and opportunities to expand their routine prospective collection and feedback to help drive improvements in the quality of care received by people undergoing radiation therapy.
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Affiliation(s)
- Susan V Harden
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kim-Lin Chiew
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, New South Wales, Australia.,South Western Sydney Clinical School, UNSW Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Jeremy Millar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Shalini K Vinod
- South Western Sydney Clinical School, UNSW Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.,Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia
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Sampurno F, Kowalski C, Connor SE, Nguyen AV, Acuña ÀP, Ng CF, Foster C, Feick G, Boronat OG, Dieng S, Brglevska S, Ferrante S, Leung S, Villanti P, Moore CM, Graham ID, Millar JL, Litwin MS, Papa N. Knowledge and insights from a maturing international clinical quality registry. J Am Med Inform Assoc 2022; 29:964-969. [PMID: 35048976 PMCID: PMC9006702 DOI: 10.1093/jamia/ocab281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/17/2021] [Accepted: 12/06/2021] [Indexed: 01/22/2023] Open
Abstract
Since 2017, the TrueNTH Global Registry (TNGR) has aimed to drive improvement in patient outcomes for individuals with localized prostate cancer by collating data from healthcare institutions across 13 countries. As TNGR matures, a systematic evaluation of existing processes and documents is necessary to evaluate whether the registry is operating as intended. The main supporting documents: protocol and data dictionary, were comprehensively reviewed in a series of meetings over a 10-month period by an international working group. In parallel, individual consultations with local institutions regarding a benchmarking quality-of-care report were conducted. Four consensus areas for improvement emerged: updating operational definitions, appraisal of the recruitment process, refinement of data elements, and improvement of data quality and reporting. Recommendations presented were drawn from our collective experience and accumulated knowledge in operating an international registry. These can be readily generalized to other health-related reporting programs beyond clinical registries.
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Affiliation(s)
- Fanny Sampurno
- Corresponding Author: Fanny Sampurno, BA, BSc (Hons), School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia;
| | | | - Sarah E Connor
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Anissa V Nguyen
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Àngels Pont Acuña
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Chi-Fai Ng
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Claire Foster
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Günter Feick
- Patient Support Association Bundesverband Prostatakrebs Selbsthilfe, Bonn, Germany
| | - Olatz Garin Boronat
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | - Stephanie Ferrante
- Department of Urology, University of Michigan (on behalf of MUSIC), Ann Arbor, Michigan, USA
| | - Steven Leung
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Caroline M Moore
- Department of Urology, Division of Surgical and Interventional Science, University College London, London, UK
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeremy L Millar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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