KEY PERFORMANCE INDICATORS for Hospital Services

1 KEY PERFORMANCE INDICATORS for Hospital Services prepared by: Dr Sohail Iqbal Information System Expert TRF+, Khyber Pakhtunkhwa January 10, 2017 ii Contents 1. 1 2. 2 3. System 3 Management Levels .. 3 PERFORMANCE domains .. 4 PERFORMANCE measures (KPIs) .. 5 Data sources .. 6 Configuring Scorecards .. 7 Benchmarks and PERFORMANCE Standards .. 8 Weightage / Formula / Scoring Engine .. 8 Cascading Measures .. 10 Processes and tools .. 10 Data collection process .. 11 Data capture tools .. 11 Web-based data management and reporting system.

2 11 4. KPIs Summary List of Hospital Services (Total KPIs: 18, Total Score: 90).. 18 5. KPI Details of Hospitals Year: 2016 (Total KPIs: 18, Total Score: 90).. 20 Annex Filled Post Index : Percentage of essential posts filled against sanctioned 38 Annex - Staff Presence Index : Percentage of staff 40 Annex - : Drug Availability Index (DHIS) Secondary 41 Annex - : Essential Equipment Availability and Functionality Index (IMU) Secondary 42 iii List of Abbreviations CMW Community Midwife DFID Department for International Development DGHS Director General of Health Services DHDC District Healthcare Development Center DHIS District Health Information System DoH Department of Health DHO District Health Officer DDOH Deputy District Health Officer EPI Expanded Programme on Immunization FP Family Planning IMR Infant Mortality Rate KPI Key PERFORMANCE indicator LHW Lady Health Worker M&E monitoring and Evaluation MDG Millennium Development Goals MIS Management Information

3 System MMR Maternal Mortality Ratio MNCH Maternal, Newborn and Child Health NP National Programme PHS Public Health Specialist HSRP Health Sector Reform Project RHIS Routine Health Information System TA Technical Assistance TBC TB Control iv TOT Training of Trainers TRF Technical Resource Facility WFP World Food Programme WHO World Health Organization Revised KPIs for District Health Services 2016 2017 1 1. Introduction The Government of the Khyber Pakhtunkhwa is committed to provide better health Services to its people and took significant initiatives in this direction.

4 The prime focus is on the health service delivery, reduction of IMR, MMR and the improvement in mother and child healthcare Services through improving the access, quality and equity of the Services . The overall PERFORMANCE of the Department of Health (DoH) depends on the PERFORMANCE of its managers and health delivery institutions. The PERFORMANCE can be measured through systematic collection of information (data) and the analysis of outcomes and its impacts on the society. Many MIS are functioning within the department, that collect data of the different vertical programees.

5 However, in the context of devolving and restructuring of the of health programmes, a comprehensive and integrated M&E system is deployed that would provide basis for PERFORMANCE evaluation at various levels. For this purpose, the DoH took initiative and conceptualized an M&E system that includes comprehensive system for data collection, reporting and validation. The system comprises of a set of agreed Key PERFORMANCE INDICATORS (KPIs) for monitoring of district health Services and measure the PERFORMANCE of managerial / supervisory tiers including Directorate General of Health Services Khyber Pakhtunkhwa (provincial level) and District Health Officers (District Heath Management).

6 The system measures the PERFORMANCE and direct corrective actions for the improvement of the health Services . Figure : Core Functions of Health System Planning and ManagementMonitoring and SupervisionService DeliveryProgramme ManagementGoalsRevised KPIs for District Health Services 2016 2017 2 The team of consultants held a series of consultative meetings in year 2016-2017 with the key stakeholders of Health Department Khyber Pakhtunkhwa Including DGHS Khyber Pakhtunkhwa, Provincial coordinator DHIS, Deputy Coordinator DHIS, Project Director IMU, Deputy Director EPI, representative from HSRU, Project Director Integrated Health Program.

7 Program manager of Provincial TB Program, M&E officer of MNCH program, Program manager of Hepatitis program, Manager Provincial Malaria Control (PoMC), Database Administrator DHIS, DHO Swabi, MS of DHQs and THQs and provincial Team Lead TRF+. After a series of meetings and exhaustive deliberations a final set of KPIs was agreed. To collect data, a number of existing online and offline data sources have been identified and agreed with the key stakeholders for the data collection of KPIs. The online data sources include: District Health Information System (DHIS), EPI MIS, LHW MIS, MNCH MIS and IMU database.

8 The sources regularly collect curative and preventive care INDICATORS from health facilities and vertical / special health programmes. Moreover, data for KPIs has also been collect from some offline data sources such as Provincial TB Programe (PTP), Provincial Malaria Control (PoMC) and DGHS and DHO offices. The M&E system has various management levels that include Directorate General Health Services , District Health Officers (DHO), Deputy District Officers Health (DDOH) and Medical Superintendents (MS) of secondary care hospitals (DHQ and THQ).

9 The evaluation is based on Key PERFORMANCE INDICATORS (KPI) from existing online and offline data sources as well as additional sources such as supervisory checklists. A mechanism for data validation is also been adopted to ensure reporting accuracy. The M&E system is of web-based software which will be fed by various data sources including DHIS, MISs of vertical programmes. The software processes the data from all the sources and calculate key PERFORMANCE INDICATORS with balance scorecard methodologies. 2. Objectives The main objective of the KPI system is to enable the Health Department for unbiased monitoring and PERFORMANCE analysis of various offices and institutions of the department.

10 The system will improve health service delivery and other Services by measuring and reporting key PERFORMANCE INDICATORS in various domains. The emphasis is on result-based PERFORMANCE and monitoring instead of process or activities based PERFORMANCE . Revised KPIs for District Health Services 2016 2017 3 The aim of the assignment is to design and develop a web-based PERFORMANCE monitoring and evaluation system for higher management through online dashboards by using state of the art technologies.