Clinics' output under scrutiny

A new data system to become available within the next few weeks will allow the Health Service Executive (HSE) to make comparisons for the first time between the number of patients dealt with by doctors and other healthcare staff in similar types of units across the State, writes Martin Wall, Industry Correspondent.

The HSE said that under the new system it would be able to see and compare day case rates, day of surgery admission rates and the average length of stays.

"This will enable us, based on facts, to identify if and why some facilities are achieving better results than others," the HSE said.

The Minister for Health Mary Harney said that under the new system the HSE would be able to see very transparently the amount of activity associated with each employee.

She said that, for example, the number of patients seen in similar types of out-patient clinics in various hospitals around the State would be known, as would the number of patients seen in physiotherapy departments.

The Minister suggested the availability of this new data and the ability to make comparisons between different parts of the Republic would "drive change".

"Sometimes we learn from innovation and cells of innovation, and there is much in the health services at many levels. Much of the health forum will be about translating what is happening in a particular cell of innovation to the wider system," she said. Ms Harney said she understood the new data system would be available from February or March.

In a statement, the Health Service Executive (HSE) said that it would be introducing a system that would allow it to make comparisons in three performance areas - access, integration and resources.

"In the area of access, we will be measuring how long it takes to access particular services in one part of the country as opposed to another and share the learning from the best with those that are experiencing difficulties," it said.

"At a glance we will be able to see how well services are integrated and appropriate to people's needs. For example, we will be able to see and compare day case rates, day of surgery admission rates and average length of stays. This will enable us to identify if and why some facilities are achieving better results than others," it said.

"This will in turn support the third area, which is how well each facility is using its resources. What are staff ratios, how many staff does a facility have per bed, what are the ratios between junior doctors to consultant and how absenteeism rates compare."

The HSE said that in an environment where there was a continual demand for more resources, this approach would provide a visible early warning system to enable it to identify where its resources were having the greatest impact and where remedial work was needed.

HSE chief executive Prof Brendan Drumm told The Irish Times recently that in the first two months of this year it would be working to "very detailed performance metrics for our own organisation".

"We will be able to say how many people are seen at individual [ out-patient] clinics. We will be able to say what the waiting time is in individual areas.

"We will be able to look at the number of people working in one hospital versus another hospital in terms of the workload going through it and I think that will bring fairness to the system, but equally it will allow us to set very definite targets for outpatient waiting lists and we intend to incentivise performance in that area, as we did last year [ with] . . . A&E departments," he said.