Indicator characteristics |
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Well-recognized definitions -
Clear definitions -
Evidence-based -
Inclusive (cover important areas) -
Reflect current knowledge -
Based on reliable, complete data -
Represent an “open” agenda
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Promotional strategies |
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Focus on services endorsed by a government task force -
Can be used to demonstrate clinical competence -
Credible indicators -
Indicators linked to performance incentives -
Existence of a “product” champion to enthuse and educate -
Develops capacity to monitor care
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Viewing indicators as a threat to autonomy -
Viewing indicators as not credible -
Viewing indicators as tools to penalize bad performance -
Financial penalties based on performance areas beyond the scope of professional control
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Implementation strategies |
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Use assessors with medical or research expertise -
Indicators selected sparingly -
Indicator information is part of documenting care -
Documentation method is user-friendly and guides care delivery -
Documented data are computer-ready -
Use previously developed tools -
Use of an audit tool -
There is an implementation plan -
Create a multidisciplinary quality improvement team
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Using government-associated assessors -
Lack of definitive diagnoses in charts -
Difficult-to-define intervention thresholds
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Resources |
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Information technology is current or resources available for upgrading -
Time is available for interpreting and acting on indicator data -
Practical support for data entry -
Capital available for extra costs
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Incompatible computer systems -
Generating indicators is costly -
Labour intensive -
Requirement for external staff -
Lack of computer training -
Increased workload
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Individual-level factors |
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Staff are competent in documentation -
Staff have good communication and collaboration skills -
Indicators are a personal interest or responsibility -
Staff have good computer skills
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Staff have limited computer skills -
Difficulties understanding indicator-related terminology or concepts -
Confusion in applying Read codes -
Reduced professional autonomy and trust -
Short-term expectations of improved quality of care
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Organizational-level factors |
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Multistakeholder involvement -
Board members are aligned with implementation plan -
Team agreement on purpose, benefits, and importance of indicators
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Some services not recorded in medical record or are difficult to find -
No clear responsibility for data entry -
Perceived lack of time to plan -
Lack of team approach to change -
Limited interprofessional communication
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External factors |
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