kras and kpis

7/27/2019 Kras and Kpis

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KRAs and KPIs


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Key Result Area

KRAs group strategic objectives into a

small number of areas, which make

sense.

Focuses effort on a limited number ofissues

Prevents fragmentation of effort

Facilitates communication


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KRAs

For example KRAs for the Health Service

Management Development Unit are:

Curriculum development

Collaboration with internal and externalstakeholders

Financial performance

Offshore developments Research Development


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KRAs

Example (cont)

Curriculum

Review Financial Management Topic

Aboriginal Health

Aged Care

Mental Health

Health Informatics

Web-based delivery


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KRAs Example

Hospital

Patient services

Quality and safety

Financial resource management

Human Resource Management

Community Development

Research


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NHS (UK)New Directions 2005- 2008

Patients more in control

Contribute to the community and economy

Improve health for everyone, especially thepoorest

Priorities: Access to and quality of services

Chronic disease management pathways

Commisioning skills

Appropriate (outcome based) financial incentives

Nb 5% of patients use 42% of hospital bed days

Reference: Health Service Journal 22April2004 p5 (www.hsj.co.uk)


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KRSs in the NHS

QUALITY DOMAINS Safety

Clinical effectiveness

Cost effectiveness

Governance Patient focus

Accessible and responsive care

Amenities and environment Public health

Reference: www.dh.gov.uk/consultations/LiveConsultations/fs/en


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NHS and PerformanceManagement

Independent inspecting agency : The HealthcareCommission

Standards for Better Health

Policy driven parameters of good practice Apply to whole of health system

Focus is on chronic disease and the patientexperience

Standards depend on consensus of whatconstitutes good healthcare

Reference: Health Service Journal 22 April2004: p16 18 (www.hsj.co.uk)


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KRAs

Example Department of Human Services(SA)

Key Strategic Directions Improving services for better outcomes

Increasing the States capacity to promotequality of life

Redistributing resources in a changingenvironment

Strengthening a culture of working together

Providing sound management


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KPIs

Key performance indicators are measuresfor all strategic objectives and coreprocesses, to answer the questions:

How will you (we) know that you haveachieved your strategic objectives, or at leastare making progress towards achieving them?

How do you (we) know that your coreprocesses are working well


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KPIs

Assumes that you have a strategic planand have been through a strategicplanning process

Need to measure OUTCOMES (resultsand outputs) and DRIVERS (processesand inputs)

Focus on what is important and relevantCore process: major impact on customer, profitability or

viability of the organisation


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KPIs

KPI measures (general)

Quantity

Quality

Cost

Revenue

timeliness


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HOSPITAL KPI - 1For KRA patient services:

Patient throughput by department or service e.g.emergency department, outpatients, surgical,medical

Number of patient episodes by DRG (DiagnosticRelated Group) and ALOS (Average Length ofStay)

Waiting times in emergency department

Waiting times for elective surgery

Compare this information with previous years,predicted (planned) activity or benchmark data


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KPI Patient Services (cont)

Patient satisfaction levels (PSF surveys)

New patient services developed(milestones, throughput) e..g diabetic

footcare services, womens healthservices; health screening clinic

Were anticipated milestones and throughputachieved; are we maintaining or improvinglevels of customer satisfaction?


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HOSPITAL KPIs - 2

Quality and safety: Accreditation inspections by external agencies

Clinical performance indicators: Wound infection; IV site infection

Unplanned return to theatre

Unplanned re-admission to hospital

Anaesthetic deaths

Perinatal mortality rate

Adverse drug events Critical incident notifications

Death reviews and case record audits

Patient complaints by category


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HOSPITAL KPIs - 3

Financial performance

Revenue and expenditure against budget Debts (30 days, 90 days, written off)

Capital works within budget

Debt reduction

Specific funding program deliverables


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Hospital KPIs - 4

HUMAN RESOURCE MANAGEMENT

Staff turnover

Absenteism rates Total FTEs (Full time equivalent)

Salaried staff to visiting staff ratio

% staff undergoing training and examinationresults

awards


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Hospital KPIs 4Community Development

Hospital as employer of local people

Number of community programs Health promotion activities

Links with schools

Volunteer work force


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Hospital KPIs 5Research

Research grants ($ p.a.)

Publications in refereed journals Revenue from commercialization of

research

Number of PhD students employed


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Health System KPIs - Australia Effectiveness (e.g. 5 yrs cancer survival; immunisation

rates)

Appropriate (e.g. hospital rates for Caesarian section,tonsillectomies and meringotomies, drug prescribing)

Efficient (e.g. cost per casemix (DRG) adjusted hospitaladmission; average LOS)

Responsiveness (e.g.Emergency department waitingtimes by triage category; elective surgery waiting times

Accessiblity (e.g.Number of nursing home places per 1000 > 70yrs old)

Safety (e.g.Hospital separations with adverse event)

Sustainability (e.g. %General Practitioners over 50 yrs old)

Others - e.g. continuity of care; capability)


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SMART KPIs and strategic objectives

SPECIFIC or SIMPLE

MEASURABLE

ACHIEVABLE

REALISTIC

TIMELY--------------------

kras and kpis

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