21 December 2017
The impact of public reporting: Are we making a difference?
2017 was a busy year for the NSW public healthcare system. This winter was particularly busy for hospitals across the state, with unprecedented numbers of emergency department patients, and the year as a whole saw steady increases in the number of admissions to hospital and a relatively stable amount of elective surgical procedures performed.
BHI has been busy too – releasing nine independent performance reports, five patient survey data releases and three methodological reports over the course of the year. We conducted more than 20 local health district and stakeholder briefings, presented our work at 20 international and national conferences, and continued to secure extensive media coverage for our report and data releases, bringing our work to a wide range of audiences, including the general community.
There has clearly been lots of activity for BHI, but as the year draws to a close a key question is are we making a difference? Our role is to publicly report on the performance of the NSW healthcare system – providing accountability to the Minister, parliament and people of NSW, and informing efforts to improve healthcare in the state.
We do know that public reporting is a powerful lever for change in healthcare systems. While it is always difficult to categorically measure impact and to attribute any of the improvement seen in the system to reporting efforts, there is evidence that the public reporting lever is working to improve patient experiences and outcomes here in NSW.
BHI recently surveyed its key stakeholders and 89% of them said they found our reports to be helpful for decision-making, policy formulation or other strategic objectives. About two thirds said BHI reports facilitate fair comparisons – using public reporting to highlight localised areas of excellence, and helping hospitals to compare performance with their peers and to identify local opportunities for improvement.
For several years, collaboration has been a central feature of our performance reporting efforts and we have worked with other agencies and pillar organisations to develop better, more meaningful and actionable measurement. We regularly provide information to local health districts and hospitals about their patients’ experiences and this year confirmed a pattern of significant improvement in many aspects of patient care.
During 2017, we released an update of our 30-day mortality and readmission reporting on nine clinical conditions. This was the second release of risk-standardised results and it saw several hospitals markedly decrease their mortality and readmission rates – reflecting concerted efforts to improve their performance in the period between three-year reporting cycles.
Some of our reports featured data on specific areas where there is evidence of overuse or underuse of particular treatments and these findings have been met with concentrated efforts in the system to reduce unwarranted clinical variation and to improve value – efforts that are gaining traction and delivering real change.
Our work has also contributed to the wider measurement community and we published five papers in the peer reviewed literature and sat on five international advisory committees.
Our reach through digital media is increasing – our new animated GIFs that convey key messages from our reports into the Twittersphere have helped us to engage with an interested audience. We have also seen an increase in visitors to our website – report downloads, clicks on our hospital navigator tool and BHI’s interactive data portal, Healthcare Observer, have all increased this year.
We are using our knowledge in data visualisation and communication of data to hold workshops which help other agencies consider more creative ways of engaging others with performance information.
Looking ahead to next year, we aim to develop our reporting capacity in a number of areas including mental health, Aboriginal health and in the use of more sophisticated metrics that consider inputs, activity, outcomes and patient experiences in an integrated way.
We will continue to seek to inform efforts to improve healthcare - efforts that are made by staff across the healthcare system in various organisations, settings and roles throughout NSW. We wish all of them and, importantly, all of their patients a happy and safe holiday season and a great 2018.
TagsAccessibility and timeliness 4 Admitted patients 1 Ambulance services 3 Appropriateness of healthcare 2 BHI - general 6 Challenging ideas 1 Chartpack 2 Data 8 Effectiveness of healthcare 3 Efficiency 1 Elective surgery 2 Emergency department 2 Healthcare services 6 Hospital care 5 Hospital performance 1 International data 1 Patient experience 7 Patient survey 1 Safety and risk 2
Dr Diane Watson is the Chief Executive of the Bureau of Health Information. She has 20 years of senior management experience measuring, monitoring and reporting on the performance of healthcare systems in Australia and internationally.
Lisa Corscadden is a senior researcher at the Bureau of Health Information. She has experience in healthcare research in Australia and Canada, with an interest in measuring equity in healthcare.
Lilian Daly is the Lead for Strategy and Engagement at the Bureau of Health Information. She holds a Master’s degree in public health from the University of New South Wales and has extensive experience as a healthcare clinician, researcher and educator.
Hilary is our Senior Director, Communications and Strategic Relations. She has extensive experience in developing policy and strategy around the role of information in improving healthcare.
Renee Carter is a former senior analyst at the Bureau of Health Information. She holds a Masters degree in health and social policy from the London School of Economics and a Doctorate in epidemiology from McGill University.
Jean-Frederic is the former Chief Executive of BHI. He is now Chief Executive of the Agency for Clinical Innovation.
Kim is the former Senior Director, Performance Measurement & Reporting at BHI. She has extensive experience in health services research in Australia and internationally.