farmdoc's blog post number 550

I wrote here that you can’t manage what you don’t measure. This was true last 7 June. And it’s just as true today. For example hospital performance. It needs to be managed; for it needs to be maximised. So it needs to be measured. Way back when, a bright person thought waiting list length would be the way to go. The shorter the list, the better the performance. And vice versa. In theory, yes. But things are never as simple as they seem. Especially when a hospital’s reputation, and its bonus funding, is judged by its waiting list length. So this report, of a Melbourne hospital’s inaccurate waiting list, is no surprise. As this article says, whether the inaccuracy was deliberate or due to rubbery guidelines is unclear. And it’s immaterial. The end result is ‘garbage in, garbage out’. The paper ends thus: The challenges in finding reliable measures of health system performance are not unique to waiting lists. In every area of the health care system, problems result when data used to assess access, quality of care and safety are not based on appropriate measurements. The cornerstones of epidemiologically sound data are validity and reproducibility. The identification of measures able to produce valid, reproducible data is essential for credible assessment of health system performance and to drive long-term improvements. Amen to that. Sure, you can’t manage what you can’t measure. But there’s measurement – and measurement.