Clinical performance indicators: intolerance for variety?
OBJECTIVE
The performance of NHS U.K. hospitals is under continuous scrutiny as they are constantly under pressure to perform well. A recent document published by an independent body has recommended a host of clinical indicators to assess non-financial performance of hospitals. This study aims to critically analyse the performance of a single U.K. hospital against several of these recommended indicators.


METHODS
Data presented to the Hospital Trust Board for 12 months were used for this study. Previous years' data were used wherever available.


RESULTS
Based on data analysis, this hospital's performance is extremely difficult to calculate. The indicators use complex ratios and due to lack of standardisation, the hospital performance could be interpreted as better, worse or indifferent.


CONCLUSIONS
This study analyses most of the recommended indicators. Literature review did not reveal a similar analysis of another hospital against these indicators which precludes comparison.


CONCLUSIONS
This study highlights the difficulty in comparing the performance of hospitals due to the inherent lack of consistency. Therefore it is apparent that any reward-rebuke system linked to performance should interpret the data with caution. It is therefore suggested that easy to control single value activities and standardised routine activities could be used to measure hospital performance. Alternatively, the hospital could compare with its own statistics from previous years.


CONCLUSIONS
Literature acknowledges the difficulties in measuring clinical performance. This paper elucidates these difficulties applied to the NHS and suggests alternatives.
Basu
Abhijit
A
University Hospital of South Manchester, Wythenshawe, UK. babuabhijitbasu@googlemail.com
Howell
Rosemary
R
Gopinath
Deepa
D
D019985:Benchmarking; D003428:Cross Infection / Q000453:epidemiology; D006739:Hospital Administration; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom