Uses and abuses of performance data in healthcare

Released

21 April 2015

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Measurement of performance in the healthcare sector is essential for transparency and accountability, and to support improvement. However, these improvements are undermined by weaknesses in the generation of data and metrics. This report outlines five steps that are not currently being addressed by policy but could significantly reduce data abuse and increase the benefit that can be gained through the use of performance data:

  1. Make data quality as important as hitting targets – By initiating a long term audit programme to tackle misreporting and incomplete or inaccurate data recording.
  2. Measure the context not just the indicator – Keeping performance measures under constant review, perhaps by multi-disciplinary specialist groups, including Royal Colleges and patient organisations.
  3. Avoid thresholds and consider the potential to incentivise ‘gaming’ in the design of metrics – Performance measures should be assessed according to the likelihood they will encourage abuse. Thresholds should be avoided wherever possible.
  4. Be more open – Making data underlying performance management widely available and promoting ongoing assessment of the degree to which metrics are being gamed.
  5. Apply measures fairly – In order to recognise legitimate mitigating factors such as resources and pressures outside the control of the organisation.