1. Information for the Future Sue Hallwright 29 July 2011

2. What is our (health system) purpose? Fewer people become unwell Unwell people get better quicker People relapse less often People with long term conditions live full lives

3. Effective policies Informed choices High quality services Good investment decisions How can information (about services) help?

4. Policy-makers Consumers Staff and Managers Funders Who needs information?

5. What do they need to know?

6. The Counties Manukau Experience Collaborative annual planning for services Understanding the whole “system” Improving delivery of services

7. Community Living Service Benchmarking example NHI Based Reporting to DHB Linked to DHB information in database Benchmarking Dashboards generated monthly Quarterly Provider Benchmarking Forum

8. Improving delivery of services Why benchmark? To collectively improve our performance* individual teams types of service To justify continued investment by demonstrating what works well, for whom, under what circumstances and at what cost. * IHI Triple Aim: improve health outcomes improve consumer experience Improve value for money

9. Improving delivery of services Why benchmark? To allow providers to identify and tackle issues together To enable providers to reassure funders that they are proactively measuring and lifting performance In a time of fiscal constraint this is even more important than it was before

10. Improving delivery of services What do we benchmark? Consumers (who used the service?) Outcomes (impact of service?) – for a particular consumer group Services (what was done?) – for a particular consumer group Quality (how good was it?)

11. Improving delivery of services Choosing the 17 reports Interviewed people about how they would choose a service: Do people like me get better using this service? Client groups – diagnosis, gender, ethnicity Outcomes for these client groups? What range services/treatments will I be likely to access if I use this service? Service mix Does the service use force? Rates of compulsory care Will the service help stop me getting sick again? Relapse prevention How much does the service cost? cost per hour

12. Current CLS Reports Consumers (who used the service?)  Diagnosis and duration of care  Age groups – current clients  Average number of clients per actual FTE  % of current clients seen by gender & ethnicity compared to DHB population Outcomes (impact of service?)  Change in housing status since registration – clients current during quarter  Change in housing status – all exited clients  Change in employment status since registration – clients current during quarter  Change in employment status – all exited clients Services (what was done?)  average monthly cost for clients – last 12 months or since registration - current  average monthly cost - last 12 months or since registration – exited clients  Percentage of current clients seen in the last 3 months  Average cost per hour – direct delivery (monthly)  Frequency distribution of total direct delivery time (monthly) Quality (how good was it?)  % of current clients in services >3 months who have used respite or inpatient services in last 3 months  % of current clients in service > 3 months who are currently under CTO  average length of stay – current clients  12 month rolling average length of stay – exited clients

13. Sample Report: Relapse (benchmark)

14. Team A Sample report: Relapse (Team A over time)

15. Improving delivery of services How does it work? DHB sends each team benchmarked dashboard individual dashboard (last 12 months) Quarterly forum offers an opportunity to To discuss interpretation of reports Provide the context/story behind them Learn from others about good practice Question one another

16. Improving delivery of services How does it work? Within organisations: Providers disseminate the reports and Educate staff about them Involve workforce in the change process Build team pride Celebrate change Encourage critical reflective practice In some instances DHB partners are also included

17. Improving delivery of services What do CLS providers think? Provider feedback about the process is very positive Provider participants would not choose to stop the benchmarking process, despite the added reporting burden !!!

18. Improving delivery of services What next? Extend to other services Acute services (provider arm and NGO) Community support servicees Residential services ”Locality” DHB and NGO benchmarking?

19. The future of information: Continually expand the availability of information for: Consumers Staff Service Managers Funders of Services Organisational Leaders Policy-Makers Governments

20. The future of information: Create “learning systems” that Use information Reflect improve and innovate at all levels Find more ways to hear the voices of consumers (experience of services)

21. Thank You