Can we improve the health system with performance reporting?

29 May 2014
  • Advanced healthcare systems are moving toward greater efficiency, transparency and accountability, and this trend will continue, particularly in fiscally-constrained environments
  • There is no single measure that will improve service delivery and patient outcomes, ensure financial sustainability and increase accountability and transparency in a health system
  • Performance reporting in healthcare will work if properly developed and implemented keeping the following twelve lessons in mind:

Program design

  • Understand the social, political and economic considerations carefully before setting targets, monitoring performance and reporting on them
  • Strive for mandatory, system-wide participation
  • Allow health providers and organisations to drive improvements in a devolved manner, which are patient-centred
  • Strive for more than just wait-time measures—such measures could include re-admission rates, ward infection rates and in-hospital death rates
  • Include both public and non-public performance reporting mechanisms
  • Be mindful of minimising dysfunctional, unintended consequences
  • Always pilot before rolling out

Data collection and reporting

  • Strive for continual design, accuracy and relevancy testing of measures and the way data are collected and reported
  • Ensure data collection is not an end in itself but a driver of positive change within the health system, and avoid onerous data collection and reporting overburden
  • Real-time reporting should be the goal, which delivers comparative clinical performance data back to health service providers and organisations


  • Engage key stakeholders, especially clinicians and senior leadership, but also the media and general public
  • Change the culture of provider organisations to foster learning over punishing and judging, which also allows clinical staff to raise questions and concerns
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