Patient and health professional perspectives on performance measurement in oncology.

Description

Performance data (PD) can be used for benchmarking but seems to have had little impact on improvements in health care. Use of PD might be encouraged if perceived as relevant. This study was conducted to compare what stakeholders knew about performance measurement (PM) and whether they would use PD, which indicators they valued, and their beliefs regarding consumer involvement. It employed semi-structured interviews with 15 colorectal cancer patients and 15 health professionals, followed by qualitative data analysis.Role (patients, physicians, nurses and managers) and patient factors (sex, age) influenced knowledge, attitudes and beliefs about PM and the use of PD, as well as perceived importance of indicators. These differences became apparent only through detailed discussion, and not indicator rating, therefore in person consensus is an important aspect of the indicator selection process. All health professionals and patients less than 70 years of age believed that patients should be involved in the selection of indicators for performance measurement, although patients desired fully shared mechanisms, while health professionals believed they should make final decisions. These results suggest that all stakeholder groups, including male and female patients less than 70 years of age, be involved in indicator selection. Nurses could serve as patient proxies because their views were often similar.Perspectives on PM had not been thoroughly explored, particularly in Canada, nor for a specific condition such as cancer. This information can be used to refine current indicator development methods and reporting strategies so that PD is more relevant to these stakeholders. Only by increasing the use of PD can the quality of health care truly be maximized.While managers remain an appropriate target for delivering PD, nurses expressed similar levels of knowledge and interest in PD, and should also be the recipients of this information. Performance data might be better received by physicians if communicated in confidence every six to 12 months, with detailed information to enable critical appraisal. Overall, health professionals were unaware of how their organizations applied PD so more investigation of organizational quality culture may be warranted.

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