ANALYSIS:System measures how a hospital is delivering services and whether it is meeting targets, writes DR MUIRIS HOUSTON
THE LAUNCH of HealthStat by the Health Service Executive is a true milestone in the development of the Republic’s health service.
Long handicapped by a lack of information, the health system has floundered with projections and platitudes replacing hard factual information. This void fuelled uncertainty about who in the service was doing what and how much it really cost.
Now, if the chairwoman of HealthStat, Maureen Lynnott, and Mark Turner, the head of the HSE support unit, deliver on their promises, light will finally be shone into some of the darkest recesses of our hospitals and community services.
From yesterday, detailed monthly results from 29 hospitals will be available online at www.hse.ie.
Next year, a measurement of health and social care services provided in the community by local health offices will be added to the HealthStat site.
HealthStat is essentially a performance information and improvement system.
It measures how well a hospital is delivering services and whether it is meeting performance targets. It is not a quality assurance system for clinical activities, something that will be delivered separately in the future.
With a focus on follow-up and the free availability of performance indicators, HealthStat should encourage hospitals to work towards improving their performance across a broad range of parameters.
The figures produced by HealthStat will be grouped into three areas – access, integration and resources. Access means the waiting times that people experience. Integration is a measure of how patient-centred health services are. Whether a hospital is making good use of its human and financial resources will be assessed under the resources banner.
Information must be conveyed in a user-friendly manner and the HSE has chosen to do that using a traffic light system of results. Green signals good performance, amber means average and red means unsatisfactory and is a signal to a hospital or service that a particular parameter requires urgent attention. As well as being available to the public and the media, HealthStat figures will be discussed at a monthly forum attended by the chief executive of the HSE and individual hospitals’ chief executives.
So what kind of data can we read about? Waiting times to see a consultant, how long to obtain physiotherapy and the time you will have to wait to get an X-ray are examples of the data available for most public hospitals. Each graphic will have a performance target clearly shown. These targets have been calculated based on a mixture of current national plans and international best practice data.
One of the most striking statistics to emerge from the first tranche of data is the percentage of patients who do not attend consultant out-patient clinics. In the case of one hospital in December, some 3,000 patients did not turn up for their appointments. Given the lengthy waiting times for certain specialities, this is an astonishing figure. DNA (did not attend) rates of 15-20 per cent are peppered throughout the figures published yesterday. This is a huge waste of resources and public money.
It must be analysed quickly and urgently; patients must be asked why they are not turning up. Are they accessing care privately or through the accident and emergency department? Do nine-to-five appointment times simply not suit? Were the referrals appropriate? And are the hospitals communicating appointment details in a timely manner, using the latest technology to send reminders close to the actual appointment date? The provision of quality information about our public health service is long overdue.
The HSE must be credited with finally getting there, with just one caveat: recent experience in the UK has shown that the pursuit of performance targets must not be done at the expense of individual patient care.