PHECC Key Performance Indicators (KPIs)
‘Key Performance Indicators (KPIs) are measures of performance that are used by organisations to measure how well they are performing against targets or expectations. KPIs measure performance by showing trends to demonstrate that improvements are being made over time. KPIs also measure performance by comparing results against standards of other similar organisations. This helps organisations to improve the service they provide by identifying where performance is at the desired level and also to identify where improvements are required’ (HIQA)
The publication of PHECC KPIs is an exciting time for PHECC practitioners as it is the first time a measurement of clinical performance has been initiated, which is not a time-based matrix that only has relevance for time critical interventions. These KPIs have the potential to showcase the clinical excellence performed by PHECC practitioners throughout Ireland every day.
Under the leadership of Dr Geoff King (RIP), PHECC initiated and funded a project to identify KPIs for pre-hospital emergency care in Ireland. This was an academic and robust process, lead by Dr Adrian Murphy, culminating in a peer reviewed publication. (Murphy, Wakai et al. 2016).
The result of this academic process identified 101 KPIs within three Donabedian domains, structure (7), process (74) and outcome (20). This suite required further refinement to identify a measurable and manageable number of KPIs which would contribute to quality improvements in pre-hospital emergency care service provision. To achieve this objective PHECC engaged in a process under the direction of Dr Eamonn Murphy, a Professor Emeritus of Statistics, from University of Limerick. As these KPIs will have the most impact on both Dublin Fire Brigade and the National Ambulance Service a decision was made to convene the KPI selection group with representation from both organisations.
KPI Selection Group
Mr Mark Doyle, Chair – Medical Advisor to Director PHECC
Dr Adrian Murphy – Lead author of development of KPIs
Mr Cathal O’Donnell – Medical Director, National Ambulance Service
Dr Conor Deasy – Deputy Medical Director National Ambulance Service
Dr Peter O’Connor – Medical Advisor, Dublin Fire Brigade
Mr Brian Power – Programme Development Officer, PHECC
Mr Martin O’Reilly – EMS support Officer, Dublin Fire Brigade
Mr Macartan Hughes – Chief Education and Competence Assurance Officer, NAS
Mr Kieran Henry – Operational AP, National Ambulance Service
Mr Ray Carney – Operational AP, Dublin Fire Brigade
Dr Mick Molloy – Chair, Medical Advisory Group
The final selection of the KPIs went through several stages involving the KPI selection group and a wider consultation culmination in nine KPIs which were approved by Council at the May 2017 meeting. Trauma and sepsis KPIs are not included in the initial round as the Trauma Network is currently being developed nationally and sepsis is going through an international review of care bundles.
In the interest of patient safety and good clinical practice it beholds PHECC practitioners to record on the PCR emergency medications administered by persons other than themselves. As a PHECC PIN is required against the medication on the PCR it is recommended that a specific PIN ‘0000’ is allocated for non-PHECC practitioner medication administration. A doctors MC PIN or a nurses NMBI PIN should be recorded as appropriate in the ‘additional information’ section of the PCR.
The PHECC KPIs will have a three-year cycle and at the end of which KPIs may be renewed or removed from the active list. The acceptable percentage standard against each KPI shall be agreed following at least one year of data collection. Services will be encouraged to identify a baseline measurement when a KPI is initially introduced, without repercussion for below average results. This baseline shall be used to drive quality improvement performance.
In a parallel process PHECC shared its deliberations with HSE/NAS which has adopted the nine PHECC KPIs as part of their suite of KPIs.
In the
KPI standard each KPI has a narrative that explains in detail the item being measured and the standard of measurement required.
Reference
Murphy, A., et al. (2016). "Development of key performance indicators for prehospital emergency care." Emerg Med J 33(4): 286-292.