In health care, we have traditionally gauged system performance relative to specific targets or benchmarks. On its yourhealthsystem.ca website, the Canadian Institute for Health Information (CIHI) reports on a wide range of indicators related to access, quality of care, health system spending, health promotion and disease prevention, and health outcomes. From this information, we know Saskatchewan has one of the shortest wait times for hip or knee replacement surgery in Canada, but among the highest rates for 30-day readmissions. While this approach tells us how we perform relative to others or whether we have achieved a specific target or benchmark, it doesn’t provide us with much insight into why we did — or did not — meet the mark.
HQC is working with its partners – the Ministry of Health, eHealth Saskatchewan, the soon-to-be-launched Saskatchewan Health Authority, and the Saskatchewan Cancer Agency – on a new approach to measuring health system performance in Saskatchewan. As part of our provincial role in health system measurement and reporting, we are helping develop a framework that will improve our understanding of the factors that contribute to, or detract from, delivering high-quality care. In order to become a learning health system, we need to better understand the factors that enable us to achieve our targets or cause us to fall short.
Measuring health care outcomes and processes to generate evidence for decision making is a strategic priority for HQC. In January 2017 the Saskatchewan Advisory Panel on Health System Structure released their recommendations. In that report, HQC was given a mandate to monitor and report on the experience and outcomes of patient care.
This new measurement framework is based on the understanding that health care is complex, with many interconnected parts – none of which function in isolation from the others. The framework includes health system inputs, activities, outputs, and outcomes/impacts. By showing the relationship between all of these different factors, the new framework promises to help shift our focus from targets to what is required to achieve those targets.
A framework will illustrate the relationships between population health needs, what priorities must be set to address those needs, and the improvements required in those priority areas.
By early 2018, senior health care leaders in the province should be using the new framework — and related reporting standards set for the new Saskatchewan Health Authority — to set health system priorities and assess progress toward meeting targets.