title: Feasibility first: developing public performance indicators on patient safety and clinical effectiveness for Dutch hospitals.
abstract: This paper describes the development and implementation of the first national, public and obligatory set of hospital performance indicators in the Netherlands. Focusing on effectiveness and safety, the set was developed by the Dutch Health Care Inspectorate to improve the effectiveness and efficiency of their task: monitoring the quality of the care delivered by providers. In addition, the set would enhance the transparency of the hospital sector, and stimulate individual hospitals to improve their scores. Bridging some of the classic distinctions between 'internal' and 'external' indicators, the Inspectorate's vision was to rapidly produce a feasible set of indicators that would fulfill these aims, while maximally preventing 'side effects' such as misinterpretations, defensive or perverse reactions. Explicitly avoiding the trap of searching for exhaustive validity of the indicators, the inspectorate's motto was 'feasability first'. This paper describes how this simultaneously philosophical, political and pragmatic strategy played out successfully, and how the indicator set was ultimately embraced by all parties involved.
authors.affiliation: Institute of Health Policy and Management, Erasmus University Medical Centre, Rotterdam, The Netherlands. m.berg@bmg.eur.nl
authors.forename: Marc
authors.initials: M
authors.lastname: Berg
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Meijerink
authors.forename: Marit
authors.initials: M
authors.lastname: Gras
authors.forename: Anne
authors.initials: A
authors.lastname: Goossensen
authors.forename: Wim
authors.initials: W
authors.lastname: Schellekens
authors.forename: Jan
authors.initials: J
authors.lastname: Haeck
authors.forename: Marjon
authors.initials: M
authors.lastname: Kallewaard
authors.forename: Herre
authors.initials: H
authors.lastname: Kingma
mesh_terms: D019985:Benchmarking; D017598:Efficiency, Organizational; D006783:Hospitals, State; D006801:Humans; D009313:National Health Programs; D009426:Netherlands; D019984:Quality Indicators, Health Care; D017751:Safety Management / Q000592:standards*