The method of integral evaluation of the efficiency of the neurosurgical clinic based on the assessment of the degree of achievement of key performance indicators

Abstract

BACKGROUND: The efficiency of a modern clinic, including neurosurgery, is traditionally assessed through the prism over a set of indicators. However, a common approach to assessing the effectiveness of medical and preventive institutions and a corresponding set of universal private indicators that allow comparing them with each other are not available.

OBJECTIVE: To evaluate the efficacy of a neurosurgical clinic through a quality indicator perspective using the goal attainment scale.

MATERIALS AND METHODS: Eleven key indicators (target categories) were selected for the integral results assessment of the neurosurgical clinic. Calculated indicators were evaluated using a special scale — the goal achievement scale developed by Kiresyuk and Sherman.

RESULTS. Based on continuous analysis conducted on the key work parameters in the Neurosurgery Center from 2014 to 2021, the target indicators were “weighed” and indicators ("0") were formed, relative to which the degree of goal achievement was subsequently assessed (from "+2" to "–2"). The level required to achieve the targets was calculated in the web application. The results of the clinic's work in 2021 have significantly improved by some indicators (number of performed operations, postoperative mortality, respiratory and urinary system infections, surgical wound infections (meningitis) per 100 ICU patients with severe complications), while the indicators of surgical activity, bloodstream infections and the number of revisions have deteriorated.

CONCLUSION. Qualitative and quantitative indicators of a modern clinic can be systematically analyzed to assess the effectiveness of its work using a scale for goal achievement. This scale integration into a web application makes it possible to easily and quickly obtain information about the degree of goal achievement in a real-time mode and makes it possible to conduct external benchmarking.

Keywords

goal achievement scale / goal setting / target indicators / benchmarking

References

[1] Kiresuk TJ, Sherman RE. Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community Ment Health J. 1968;4(6):443–453. doi: 10.1007/BF01530764

[2] Kiresuk T.J., Sherman R.E. Goal attainment scaling: A general method for evaluating comprehensive community mental health programs // Community Ment Health J. 1968. Vol. 4, № 6. Р. 443–453. doi: 10.1007/BF01530764

[3] Zidarov D, Poissant L, Sicotte C. Healthcare executives’ readiness for a performance measurement system: A rehabilitation hospital case study. Journal of Hospital Administration. 2014;3(4):157–172. doi: 10.5430/jha.v3n4p157

[4] Zidarov D., Poissant L., Sicotte C. Healthcare executives’ readiness for a performance measurement system: A rehabilitation hospital case study // Journal of Hospital Administration. 2014. Vol. 3, № 4. Р. 157–172. doi: 10.5430/jha.v3n4p157

[5] Ahluwalia SC, Damberg CL, Silverman M, Motala A, Shekelle PG. What Defines a High-Performing Health Care Delivery System: A Systematic Review. The Joint Commission Journal on Quality and Patient Safety. 2017;43(9):450–459. doi: 10.1016/j.jcjq.2017.03.010

[6] Ahluwalia S.C., Damberg C.L., Silverman M., Motala A., Shekelle P.G. What Defines a High-Performing Health Care Delivery System: A Systematic Review // The Joint Commission Journal on Quality and Patient Safety. 2017. Vol. 43, Issue 9. Р. 450–459. doi: 10.1016/j.jcjq.2017.03.010

[7] Taraskina YuV. Indicators of business processes as a basis for evaluating the effectiveness of an organization. Bulletin of the Astrakhan State Technical University. Series: Economics. 2015;(4):15–22. (In Russ).

[8] Тараскина Ю.В. Показатели бизнес-процессов как основа оценки эффективности деятельности организации // Вестник Астраханского государственного технического университета. Серия: Экономика. 2015. № 4. С. 15–22.

[9] Turenko TA. Methodological approaches to assessing the effectiveness and efficiency of healthcare based on official statistics. Izvestiya Irkutsk State Academy of Economics. 2013;(4):120–125. (In Russ).

[10] Туренко Т.А. Методические подходы к оценке результативности и эффективности здравоохранения на основе данных официальной статистики // Известия Иркутской государственной экономической академии. 2013. № 4. С. 120–125.

[11] Cantor VJ, Poh KL. Integrated Analysis of Healthcare Efficiency: A Systematic Review. J Med Syst. 2018;42(1):1–23. doi: 10.1007/s10916-017-0848-7

[12] Cantor V.J., Poh K.L. Integrated Analysis of Healthcare Efficiency: A Systematic Review // J Med Syst. 2018. Vol. 42, № 1. Р. 1–23. doi: 10.1007/s10916-017-0848-7

[13] Hadji B, Meyer R, Melikeche S, Escalon S, Degoulet P. Assessing the relationships between hospital resources and activities: a systematic review. Journal of Medical Systems. 2014;38(10):127. doi: 10.1007/s10916-014-0127-9

[14] Hadji B., Meyer R., Melikeche S., Escalon S., Degoulet P. Assessing the relationships between hospital resources and activities: a systematic review // Journal of Medical Systems. 2014. Vol. 38, Issue 10. Р. 127. doi: 10.1007/s10916-014-0127-9

[15] Nazarenko AG. The choice of optimal surgical tactics for degenerative diseases of the lumbosacral spine using an information and analytical system and computer modeling [dissertation]. Moscow; 2012. Available from: https://new-disser.ru/_avtoreferats/01005093867.pdf?ysclid=lkwl77r8dt931864027 (In Russ).

[16] Назаренко А.Г. Выбор оптимальной хирургической тактики при дегенеративных заболеваниях пояснично-крестцового отдела позвоночника с использованием информационно-аналитической системы и компьютерного моделирования: дис. … д-ра мед. наук. Москва, 2012. Режим доступа: https://new-disser.ru/_avtoreferats/01005093867.pdf?ysclid=lkwl77r8dt931864027

[17] Nazarenko AG, Ivanov IV, Shchesyul AG, Shimansky VN, Savin IA, Gadzhieva OA, Ershova ON, Matueva NM, Konovalov NA, Shultz MA, Danilov GV, Sosnin AD, Baranich AI, Sharipov OI. Monitoring of triggers of adverse events as a tool for quality management of medical care in a neurosurgical clinic. Invitation to a discussion. Questions of neurosurgery. 2019;83(6):35–43. (In Russ). doi: 10.17116/neiro20198306135/

[18] Назаренко А.Г., Иванов И.В., Щесюль А.Г., Шиманский В.Н., Савин И.А., Гаджиева О.А., Ершова О.Н., Матуева Н.М., Коновалов Н.А., Шульц М.А., Данилов Г.В., Соснин А.Д., Баранич А.И., Шарипов О.И. Мониторинг триггеров неблагоприятных событий как инструмент управления качеством медицинской помощи в нейрохирургической клинике. Приглашение к дискуссии // Вопросы нейрохирургии. 2019. Т. 83, № 6. С. 35–43. doi: 10.17116/neiro20198306135/

[19] Nazarenko AG, Usachev DYu, Konovalov NA, Tanyashin SV, Sharipov OI, Shultz MA, Kalinin PL. Analysis of key indicators of the quality of the neurosurgical clinic. Quality management in medicine. 2021;(1):97–103. (In Russ).

[20] Назаренко А.Г., Усачёв Д.Ю., Коновалов Н.А., Таняшин С.В., Шарипов О.И., Шульц М.А., Калинин П.Л. Анализ ключевых показателей качества работы нейрохирургической клиники // Менеджмент качества в медицине. 2021. № 1. С. 97–103.

[21] Lichiello P, Turnock BJ. Guidebook for Performance Measurement. 1999. Available from: https://www.phf.org/resourcestools/Documents/pmcguidebook.pdf

[22] Lichiello P., Turnock B.J. Guidebook for Performance Measurement. 1999. Режим доступа: https://www.phf.org/resourcestools/Documents/pmcguidebook.pdf

[23] Wolk A, Dholakia A, Kreitz K. Building a Performance Measurement System. Cambridge: Root Cause; 2009.

[24] Wolk A., Dholakia A., Kreitz K. Building a Performance Measurement System. Cambridge: Root Cause, 2009.

[25] Nazarenko GI. Goal-setting in clinical practice. N.N. Priorov Journal of Traumatology and Orthopedics. 2008;15(4):3–10. (In Russ).

[26] Назаренко Г.И. Целеполагание в клинической практике // Вестник травматологии и ортопедии им. Н.Н. Приорова. 2008. Т. 15, № 4. С. 3–10.

[27] Petlenko VP, Baranovsky AYu. Methodological foundations of forecasting in medicine. Clinical medicine. 1992;70(1):3–8. (In Russ).

[28] Петленко В.П., Барановский А.Ю. Методологические основы прогнозирования в медицине // Клиническая медицина. 1992. Т. 70, № 1. С. 3–8.

[29] Ryazanov VV. Logical patterns in recognition problems (parametric approach). Computational Mathematics and Mathematical Physics. 2007;47(10):173–1808. (In Russ). doi: 10.1134/S0965542507100120

[30] Рязанов В.В. Логические закономерности в задачах распознавания (параметрический подход) // Журн. вычислит. математики и математ. физики. 2007. Т. 47, № 10. С. 173–1808. doi: 10.1134/S0965542507100120

[31] March JG, Sutton RI. Organizational performance as a dependent variable. Organization Science. 1997;8(6):697–706. doi: 10.1287/orsc.8.6.698

[32] March J.G., Sutton R.I. Organizational performance as a dependent variable // Organization Science. 1997. Vol. 8, Issue 6. P. 697–706. doi: 10.1287/orsc.8.6.698

RIGHTS & PERMISSIONS

Eco-Vector