The Journey toward High Performance and Excellent Quality

Abstract

Signalling the importance of healthcare quality and quality improvement plans in Ontario, the province's Excellent Care for all act requires all hospitals to publish quality improvement plans, conduct regular patient and staff surveys, and forge a clear link between hospital CEO compensation and quality improvement. The act also clarifies and strengthens links between evidence and quality of care. The act is an important step toward Ontario's becoming a high-performing healthcare system. Yet as some of the papers in this special issue of Healthcare Quarterly discuss, there remains much to be done. Other papers and interviews draw attention to the importance of strategic and system design levers-particularly setting goals, public reporting of results and clinician engagement-to stimulating improvement. Yet other papers present a diverse range of perspectives and ideas on how to pursue improvement and to bridge the knowing-doing gap in healthcare so that evidence informs better practice. Achieving and sustaining high performance in healthcare will require dedicated effort by everyone in every healthcare organization. With a view to the future, the act allows for the expansion of the quality obligations initially applicable to hospitals to other publicly funded health organizations.

Evaluation performance in health regions in Brazil

“…The performance and efficiency were not determined by the level of financing in the regions that had better results, Sterea Ellada and Thessaly (Greece), Extremadura (Spain), Alanda (Sweden), North (Portugal) and Zealand (The Netherlands). 23 Brown et al 24 recommend for an efficient health system, it is necessary to exist specific objective with plans and aims to be achieved, along with frequent reports with the results of improvement and, especially, with the participation of medical professionals in this discussion aligned to the same targets.…”

Measurement of Health System Performance at District Level: A Study Protocol

“… 8-10 Frameworks exploring specific building blocks of the healthcare system, like Governance, and related performance evaluation systems have also been developed and compared for use at regional level. 11 , 12 However, limited efforts have been seen in this direction in low and middle income countries (LMIC). Ministry of Health, Republic of Uganda has been producing an annual health system performance report since 2001 containing information on health sector performance (inputs and processes), health service coverage levels and local governance performance using league table analysis.…”

Insights on the effectiveness of reward schemes from 10‐year longitudinal case studies in 2 Italian regions.

“…Indeed, some authors believe that when quality of care and appropriateness is pursued, in the long run, also the financial sustainability of the health care systems will be ensured. [60][61][62] In this perspective, the inclusion of a large set of indicators seems to be a good solution (how many targets to set), as suggested by the shift of Lombardy's reward scheme: when the region started to link performance of GMs to a larger set of health care goals (although not always expressed in quantitative terms and clear targets) the overall performance, measured through the ELC score, improved. Although single individuals may control a few activities, it is also true that…”