Which comprehensive framework to evaluate clinical performance in research and teaching hospital? [Poster]

Background Clinical Performance Evaluation (CPE), as a proxy of effectiveness and quality of care, is a key issue in public health. While there are diverse frameworks for CPE of healthcare systems as a whole, less attention has been paid on hospital care. The aim of our study is to define a comprehensive set of clinical CPE indicators among Research and Teaching Hospitals (R&THs). R&THs were selected as they integrate research, education and healthcare, and are expected to deliver higher quality of care. Methods Through a critical search we selected seven performance evaluation frameworks from national agencies (Australia, Canada, Denmark, United Kingdom and USA) and international agencies (OECD, WHO) CPE frameworks were analyzed, focusing on dimensions related to healthcare outcomes appraisal. Then institutional healthcare agencies’ websites were scanned to select indicators dealing with CPE. A complementary literature search on Pubmed and Scopus search engines was performed. A Delphi round involving 12 public health experts was applied to select sustainable and relevant indicators and their matching benchmarks/standards. Results CPE was evaluated through 26 indicators belonging to effectiveness/improvement of health outcomes and appropriateness. Among this, through the application of the Delphi, we selected 12 indicators suitable to R&THs CPE. These indicators mainly explored cardiovascular, obstetrics, neurological, trauma and respiratory diseases for nine of 12 reported benchmarks and/or standard applicable to R&THs. Conclusions Given the growing interest in CPE, also due to Directory 24/11 on patient’s mobility to ensure effectiveness and high quality of care is a key concern in hospital care management. Our study identifies a set of indicators suitable for measuring CPE. It supports the continuous quality improvement management by giving specific evidence based benchmarks for each measure. This should be a starting point for the improvement and the development of quality and effectiveness of care in hospitals. Key messages CPE should support healthcare organizations towards quality improvement. This switches interest in research and evaluation from efficiency to outcome. Healthcare organizations should base resource allocation and financial incentives on robust evaluation frameworks. This would gain transparency and public reporting, too.