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KPI Framework for NZ Mental Health

and Addiction Services

July 2011

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

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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

Sub-set of supplementary indicators

Community service user-related timeSupp 44.

Percentage of HoNOS compliant dischargesSupp 27.

Percentage of total cost that is acute inpatient costSupp 29.

Percentage of total cost that is community care costSupp 30.

Pop 06 access to serviceSupp 31.

DHB adult funding per head of populationSupp 35.

Cost per acute inpatient bed ($000)Supp 16.

Cost per contact hourSupp 17.

Community care cost per contactSupp 13.

Acute inpatient unit beds per 100,000 population Supp 4.

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 19. Post-discharge community care

KPI 8. Average length of acute inpatient stay

KPI 28. Acute inpatient readmissions rate

Continuity of care spider web cluster 2008/2009

KPI 8. Average length of acute inpatient stay

KPI 18. Pre-admission community care

KPI 28. Acute inpatient readmissions rate

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

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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

Sustainability/Future direction