Towards a performance measurement system for health equity in a local health integration network

While there is a growing literature on building performance measurement systems for health equities, this literature for the most part has not dealt with the challenges of coordinating the various parts of the system, the heterogeneous nature of such systems, or how evaluations and measurement can themselves improve performance. This paper describes the initial steps taken to build a performance measurement system to coordinate health equity across 18 hospitals led by the Toronto Central Local Health Integration Network, which is a regional health authority serving a population of more than 2.5 million residents (near in population to Chicago and Rome) and the most socially diverse urban network in Ontario, Canada. This paper also describes some principles that can help inform a performance measurement system. The innovative aspect of this paper is that these principles were developed through feedback by the hospitals.