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Trust in performance indicators?

H T Davies1, J Lampel

  • 1Department of Management, University of St Andrews, Scotland, UK. hd@st-and.ac.uk

Quality in Health Care : QHC
|August 5, 1998
PubMed
Summary

Published health outcome data, while intended to improve healthcare quality, may be counterproductive. An alternative approach emphasizes trust in professionalism for better quality enhancements.

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Area of Science:

  • Health Services Research
  • Quality Improvement
  • Public Health Policy

Background:

  • The late 20th century saw increased use of performance indicators in healthcare management.
  • Health outcomes have become a recent focus for performance measurement.
  • League tables of health outcomes are published in the US, Scotland, and now England and Wales.

Purpose of the Study:

  • To evaluate the impact of publishing health outcome data on quality improvement efforts.
  • To question whether the benefits of publishing health outcomes outweigh their limitations.
  • To propose an alternative strategy for enhancing healthcare quality.

Main Methods:

  • Critical analysis of the proliferation and impact of performance indicators in health services.
  • Review of the development and publication of health outcome league tables.
  • Argumentative approach to assess the effectiveness and potential drawbacks of published health outcomes.

Main Results:

  • Publication of health outcome data has proceeded despite concerns about its meaningfulness and utility.
  • The approach of forcing improvements through published health outcomes can be counterproductive.
  • Existing methods may subvert more constructive quality enhancement strategies.

Conclusions:

  • Publishing health outcome data may hinder rather than help quality improvement efforts.
  • An alternative approach focusing on enhanced trust in healthcare professionalism is proposed.
  • Fostering professionalism is suggested as a more constructive basis for quality enhancements.

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