The use of indicators to monitor quality of care

What do we understand as indicators?

In 2016, AQuAS (Catalan Agency for Health Quality and Evaluation), defined indicators used to evaluate the clinical and healthcare quality as a measurement instrument used to evaluate or measure specific aspects of the quality of care.

AQuAS held that the ultimate goal of the analysis of healthcare indicators is to improve quality: evaluate to improve.

Jan Mainz in his article “Defining and classifying clinical indicators for quality improvement” Stated that clinical indicators measure the extent to which set targets are achieved. They are expressed as numbers, rates, or averages that can provide a basis for clinicians, organizations, and planners aiming to achieve improvement in care and the processes by which patient care is provided

How indicators are defined?

Different methodologies, as systematic literature review and Key Opinion Leaders (KOL) assumptions, could be combined to define the most suitable indicators after a conceptual framework have been built.

The reference conceptual framework has to contemplate all the essential aspects that wants to be evaluated as well as the targeted population. The OECD developed in 2006 a Health Care Quality Framework based on the most used dimensions of care. These dimensions were the following:

  • Effectiveness: the degree of achieving desirable outcomes, given the correct provision of evidence-based healthcare services to all who could benefit, but not to those who would not benefit
  • Safety: the degree to which health care processes avoid, prevent, and ameliorate adverse outcomes or injuries that stem from the processes of health care itself
  • Responsiveness: how a system treats people to meet their legitimate non-health expectations
  • Accessibility: the ease with which health services are reached.
  • Equity: the extent to which the distribution of healthcare and its benefits among a people is fair.
  • Efficiency: the system’s optimal use of available resources to yield maximum benefits or results

Once the framework is built, systematic literature review to understand which indicators have been used in the past and KOL assumptions might be combined, to finally define the best indicators.

Analysis of results

Once the analysis has been conducted, the indicators are useful to understand, how far our actual performance is from what it should be,  given the current technologies and resources or/and how our outcomes are in comparison to other organisations or institutions indicators.

HiTT’s team have over 20 years of experience in the national and European healthcare system, which becomes a key asset when conducting processes/outcome quality analysis for public or private health care institutions.