KPI Framework for NZ Mental Health and Addiction Services July 2011 1
Outline Background KPIs and targets defined Published KPI data Outcomes Project milestones
Background Shift from information collection to information use Provider led initiative since 2006 KPIs for quality improvement purposes Sector-wide benchmarking Long term view: benchmarking across the mental health and addiction sector Embedded in local, regional and national activity Peer groupings between providers formed based on issues of common interest
Use the information to Understand their organisation s comparative performance Introduce data and service improvement initiatives Improve outcomes for service users
The KPI project lifecycle
Special projects Special projects in progress: Development of new/and or replacement KPIs Comparative consumer profiles Data impact of regional service provision NGO engagement in benchmarking Sub-groups of interested participants Make recommendations to the wider project group
KPIs and targets defined
KPIs defined KPIs function as a yardstick for performance They provide information about how well a service is performing KPIs are most meaningful when interpreted in groups or clusters such as continuity of care, productivity and efficiency
Targets developed during Phase II Considerable discussion and debate Provisional only, will require further testing Focus on any one indicator and its target could provide a distorted view of performance Interrelationships between the indicators and their targets are important Targets are most meaningful when they are applied to clusters of indicators
Targets may be expressed in different ways They may be: Minimum performance (incorporates alarm concept) Optimum performance or good practice Alarm or alert targets They may be expressed as: Equal to x Threshold values either greater than or less than A range
Published KPI data 10 Test Phase indicators (13 in Phase III) 40 + supplementary indicators Stratified by ethnicity Maori, Pacific, Other Grouped in themes: Access to service Continuity of care Productivity Efficiency Organisational health
Core indicators 1. Inpatient change in the total HONOS scale (now percentage of HoNOS compliant discharges) 2. 28 day acute inpatient readmission rate 3. Average length of acute inpatient stay 4. Weekly community treatment days per clinical FTE 5. Community treatment days per service user 6. NGO services investment 7. Pre-admission community care 8. Post-discharge community care 9. Total staff turnover 10.Sick leave usage 13
Sub-set of supplementary indicators Supp 4. Supp 13. Supp 16. Supp 17. Supp 27. Supp 29. Supp 30. Supp 31. Supp 35. Supp 44. Acute inpatient unit beds per 100,000 population Community care cost per contact Cost per acute inpatient bed ($000) Cost per contact hour Percentage of HoNOS compliant discharges Percentage of total cost that is acute inpatient cost Percentage of total cost that is community care cost Pop 06 access to service DHB adult funding per head of population Community service user-related time
Published data with agreed targets
KPI 2. 28 day acute inpatient readmission rate
KPI 8. Average length of acute inpatient stay
KPI 16a. NGO services investment - Adult
KPI 19. Post-discharge community care
KPI 28. Total staff turnover
KPI 29. Sick leave usage
KPI 1. Total HoNOS score (inpatient) Effect size large (simulated data)
Continuity of care spider web cluster 2007/2008 KPI 18. Pre-admission community care KPI 28. Acute inpatient readmissions rate KPI 8. Average length of acute inpatient stay KPI 19. Post-discharge community care
Continuity of care spider web cluster 2008/2009 KPI 18. Pre-admission community care KPI 28. Acute inpatient readmissions rate KPI 8. Average length of acute inpatient stay KPI 19. Post-discharge community care
Supplementary indicators with averages
Supp 4. Acute inpatient unit beds per 100,000 population
Supp 13. Community care cost per contact
Supp 17. Cost per contact hour
Supp 18. DHB NGO funding per head of population
Supp 21. Median length of stay
Supp 26. Percentage of discharges greater than 35 days
Supp 30. Percentage of total cost that is community care cost
Supp 31. POP 06 access to service
Supp 44. Community service user-related time
Data stratified by ethnicity
KPI 2. 28 day acute inpatient readmission rate Māori
KPI 2. 28 day acute inpatient readmission rate Pacific
KPI 8. Average length of acute inpatient stay Māori
KPI 8. Average length of acute inpatient stay Pacific
Supp 26. Percentage of discharges greater than 35 days - Māori
Outcomes Effective use of data to build the indicators at provider level Provider capability to collect, report and use data Indication of the Framework s effectiveness to measure performance and improve quality Established benchmarking forums and resultant use of information for quality improvement Recommendations for whole of sector implementation 41
Sustainability/Future direction