One of the Commission’s key roles is to publish information about the quality of health care in New Zealand. This involves comparing health care services across the country and comparing what we do with the rest of the world. The Commission’s role has been likened to 'shining a light and lending a hand'. Our work in measurement and evaluation is an effective way of shining a light on the state of health care in New Zealand.
We know that measuring the right things well and publicising the results stimulates improvement in quality. It is also a matter of fairness and transparency. The public pay for health care and they have a right to know how good it is.
However, statistics can sometimes be open to misinterpretation so it’s important to be clear about why we have chosen certain measures, and why we’re publishing them. It may be to allow clinicians, patients and the public to make judgements about the quality of care, or it may be to stimulate debate and raise questions.
The Commission has a range of different measurement programmes, all with a slightly different focus. These are as follows:
- Health Quality & Safety Indicators
These are a set of high-level measures which are designed to provide the public and the health and disability sector with a clear picture of the quality and safety of health services in New Zealand.
- The Atlas of Healthcare Variation
The Atlas shows variation between the health care received by people in different geographical regions. The purpose of the Atlas is to stimulate questions and debate about why there is variation, which should then lead to improvements in our health care services.
- Quality & Safety Markers
Quality and Safety Markers are designed to track and incentivise progress in four critical areas of safety and quality. These are reducing harm from falls, hospital-acquired infections, surgery and medication safety.
- Quality Accounts
Quality Accounts require health care providers to give an account for the quality of their services in a similar way to financial accounts that show how an organisation used its money. Quality Accounts are currently being adopted in New Zealand.
Evaluating the success of improvement activities
The Commission is responsible for co-ordinating improvement programmes across a range of safety and quality topics. It is part of our responsibility to evaluate the effect of these programmes. We shall do this in ways that address the New Zealand triple aim, looking at the burden of harm reduced following the implementation of the improvement activity (in terms, for example, of increased morbidity, hospital stay or mortality) or the associated reduction in costs. In doing this we shall make a clear ‘value proposition’ for specific improvement interventions.
How it fits together
Whilst each of these measurement activities has a different purpose, and a range of different practical and technical approaches, we have sought to identify synergies between the different activities.
For example, measures used for the four priority areas will form part of the 'safety' area of the national health quality and safety indicator set, the evaluation measures from our improvement activities will help establish both measures and data sources required to support other work and the Atlas may help identify future work programmes.