4 minute read
The Healthcare World Primary Care Standards
Developed with Primary Care experts Health Care First and our data partners at Methods Analytics
Every patient in any country has the right to expect a quality of service that is measurable and measured. Standards are the explicit statements of expected quality in the performance of a healthcare activity against which these services can be evaluated.
In addition, standards allow healthcare institutions to demonstrate internationally recognised levels of performance and outcomes. They can include governance, leadership, infection prevention and control as well as clinical practice guidelines, standard operating procedures, critical paths and treatment protocols.
Standards can also be used to allow benchmarking between various organisations, enabling improvements to be incorporated. By giving reassurance to patients that their treatment and healthcare facility operates at a recognised national or international level, they are able to have confidence in the declared outcomes.
Equally, standards give governments and ministerial healthcare departments a measurable system for an overview of national healthcare o erings. Wellconstructed indicators can inform improvement through understanding how a healthcare system works and how it could be improved, to monitor how a healthcare system or service is performing against standards and provide accountability to patients, to providers and to national healthcare bodies.
Developing and implementing a robust clinical standard
Access to data permits measurement and meaningful standards, enabling easy cross reference across various specialities. It provides an understanding of the service, its scope, size of cohort of patients and how it fits with wider healthcare systems. Thorough metadata should answer a number of questions and provide measurements to answer what, when, how, where and why. It also provides knowledge of types of indicator - count, rate, ratio, percentage, mean and binary.
By ensuring the data is consistent across healthcare providers, it can be constantly reviewed to ensure the indicators are meaningful and provide insight. As healthcare becomes ever more complex, performance and accountability are important to ensure equitable high quality care. By monitoring a system or service to ascertain whether it is performing against expectation, the healthcare organisation provides accountability not only to themselves but to patients, other providers, national healthcare bodies and insurers.
Background
Patients and payors have a clear interest in understanding healthcare provision. The Healthcare World Standard for each
speciality is supported by leading NHS institutions, outlining best practice and the highest quality care. Developed with Primary Care experts, we created a set of standards that can be used to look at Primary Care Organisations and the services they provide to ensure an equitable high quality of care regardless of location.
Initially we started by researching primary care services and what standards and best practice already exist, and thinking about what good quality of care looks like for a primary care organisation.
A er compiling an initial list of more than 50 areas to explore further, there were discussions with primary care clinicians and management to refine and focus the standards, resulting in the final set of standards.
How the Standard is measured
Each theme covers the areas subject to rigorous examination that form the bedrock of the standard. For primary care, the themes are accessibility, system inclusion, information, long term condition management, organisation, responsiveness, safety, structured management and workforce.
We structured the approach under 10 overarching themes, such as accessibility, high level concepts that matter in the delivery of primary care. These split into 24 sub-standards and then these again split into 43 Standards and 111 measures. This hierarchy allows users to understand how measures contribute up, or to see how a theme, sub theme or standard is measured.
Each standard thus has its own set of measures to allow data to be collected and quality of care monitored.
Standards can be viewed as a whole, or by theme or sub theme depending on the purpose of review and what the audience requires.
Each measure has a rationale and technical metadata to inform what data is required to be collected.
The graphic below shows the standards and measures which fall under the ‘accessibility’ theme. Under the overarching theme of accessibility, there are 3 sub themes – diagnosis, appointments and access, the standards, and then the relevant measures which together make up the standard. To go alongside this high level diagram is a detailed metadata document which provides further information and guidance regarding all the individual measures. For example, in the above, the detail for the ‘timely, accurate and definitive diagnosis’ standard and the contributing ‘time to diagnosis’ measure comprises of:
Indicator type – Mean
Rationale - Delayed diagnosis is common and prevents e ective management
Numerator – Of those in the denominator, the total time (in days) from initial appointment to confirmed diagnosis
Denominator - Total number of patients diagnosed with colorectal cancer (* example condition)
Conclusion
The Healthcare World Standards will improve health, care and choice for all. They will ensure high quality care to satisfy both patient and payer by giving a measurable value to facilities such as clinics, hospitals or walk-in facilities, backed up by the world-famous NHS expertise.
