Quality in Health Care, Vol 7, 159-162

PAPERS

Trust in performance indicators?

HT Davies and J Lampel
Department of Management, University of St Andrews, Scotland, UK. hd@st- and.ac.uk

The 1980s and 90s have seen the proliferation of all forms of performance indicators as part of attempts to command and control health services. The latest area to receive attention is health outcomes. Published league tables of mortality and other health outcomes have been available in the United States for some time and in Scotland since the early 1990s; they have now been developed for England and Wales. Publication of these data has proceeded despite warnings as to their limited meaningfulness and usefulness. The time has come to ask whether the remedy is worse than the malady: are published health outcomes contributing to quality efforts or subverting more constructive approaches? This paper argues that attempts to force improvements through publishing health outcomes can be counterproductive, and outlines an alternative approach which involves fostering greater trust in professionalism as a basis for quality enhancements.

Copyright © 1998 Quality in Health Care

This article has been cited by other articles:

				M. Moy, J. Bayliss, C. Firth, J. Leggate, and R. Wood Drug using parents: an exploration of family focused support from health professionals Journal of Research in Nursing, September 1, 2007; 12(5): 551 - 561. [Abstract] [PDF]

				M R Dibben and H T O Davies Trustworthy doctors in confidence building systems Qual. Saf. Health Care, April 1, 2004; 13(2): 88 - 89. [Full Text]

				T. H. Spies, H. G. A. Mokkink, P. F. De Vries Robbe, and R. P. T. M. Grol Which data source in clinical performance assessment? A pilot study comparing self-recording with patient records and observation Int. J. Qual. Health Care, February 1, 2004; 16(1): 65 - 72. [Abstract] [Full Text] [PDF]

				M Marshall and P Smith Rewarding results: using financial incentives to improve quality Qual. Saf. Health Care, December 1, 2003; 12(6): 397 - 398. [Full Text] [PDF]

				O. A. Arah, N. S. Klazinga, D. M. J. Delnoij, A. H. A. T. Asbroek, and T. Custers Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement Int. J. Qual. Health Care, October 1, 2003; 15(5): 377 - 398. [Abstract] [Full Text] [PDF]

				H. T O Davies and S. Harrison Trends in doctor-manager relationships BMJ, March 22, 2003; 326(7390): 646 - 649. [Full Text] [PDF]

				H Miles, E Litton, A Curran, L Goldsworthy, P Sharples, and A J Henderson The PATRIARCH Study. Using outcome measures for league tables: Can a North American prediction of admission score be used in a United Kingdom children's emergency department? Emerg. Med. J., November 1, 2002; 19(6): 536 - 538. [Abstract] [Full Text] [PDF]

				H. T. O. Davies, A. E. Washington, and A. B. Bindman Health Care Report Cards: Implications for Vulnerable Patient Groups and the Organizations Providing Them Care Journal of Health Politics Policy and Law, June 1, 2002; 27(3): 379 - 400. [Abstract] [PDF]

				P. Adab, A. M Rouse, M. A Mohammed, and T. Marshall Performance league tables: the NHS deserves better BMJ, January 12, 2002; 324(7329): 95 - 98. [Full Text] [PDF]

				H T O Davies Public release of performance data and quality improvement: internal responses to external data by US health care providers Qual. Saf. Health Care, June 1, 2001; 10(2): 104 - 110. [Abstract] [Full Text] [PDF]

				R G Thomson and J Lally Performance management at the crossroads in the NHS: don't go into the red Qual. Saf. Health Care, December 1, 2000; 9(4): 201 - 202. [Full Text]

				R. D. C. Gauld Big Bang and the Policy Prescription: Health Care Meets the Market in New Zealand Journal of Health Politics Policy and Law, October 1, 2000; 25(5): 815 - 844. [Abstract] [PDF]

				H. T O Davies, S. M Nutley, and R. Mannion Organisational culture and quality of health care Qual. Saf. Health Care, June 1, 2000; 9(2): 111 - 119. [Full Text]

				M. N. Marshall, P. G. Shekelle, S. Leatherman, and R. H. Brook The Public Release of Performance Data: What Do We Expect to Gain? A Review of the Evidence JAMA, April 12, 2000; 283(14): 1866 - 1874. [Abstract] [Full Text] [PDF]

				H. T O Davies and S. M Nutley Developing learning organisations in the new NHS BMJ, April 8, 2000; 320(7240): 998 - 1001. [Full Text]

				M. N Marshall Improving quality in general practice: qualitative case study of barriers faced by health authorities BMJ, July 17, 1999; 319(7203): 164 - 167. [Abstract] [Full Text]

				A. B. Bindman Can Physician Profiles Be Trusted? JAMA, June 9, 1999; 281(22): 2142 - 2143. [Full Text] [PDF]