https://doi.org/10.4081/ecj.2020.8910
Emergency Key Performance Indicators in the Italian region Friuli Venezia Giulia
Submitted: 22 February 2020
Accepted: 18 May 2020
Published: 4 September 2020
Accepted: 18 May 2020
Abstract Views: 749
PDF: 480
Appendix: 170
Appendix: 170
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Key Performance Indicators (KPI) regard key areas of a particular service which needs to be evaluated. Within the health system, they represent specific and measurable elements and are based on standards generally set by the scientific literature. KPI can be used to assess performances in different areas and achievement of goals. To develop and calculate a set of KPI in the Italian Region Friuli Venezia Giulia (1 million inhabitants) as an audit tool for the regional Emergency healthcare system, with a focus on three timedependent conditions: trauma, acute myocardial infarction, and stroke. To develop the set, a modified Delphi process was applied among Emergency care experts in Friuli Venezia Giulia. Then, the indicators were calculated from anonymous administrative health databases (Emergency Medical System, Emergency Department, hospital discharge, cardiac catheterization laboratory). Databases could be linked with each other at the individual level through a univocal stochastic key. Sensitivity analyses were conducted where different results were expected using different databases. Sixty-one indicators were calculated for the year 2018. Five indicators were summary descriptive measures, 10 were outcome measures, the others were process indicators; 20 were specific on acute myocardial infarction, 12 on trauma, 4 on stroke. Values for some indicators varied depending on the data source. These KPI provided new and interesting information and are used for periodic audit purposes in Friuli Venezia Giulia. Higher quality, completeness and richness of the administrative databases should be promoted to further increase the value of the indicators.
Sørup CM, Jacobsen P, Forberg JL. Evaluation of emergency department performance - a systematic review on recommended performance and quality-in-care measures. Scand J Trauma Resusc Emerg Med. 2013 Aug 9;21:62. doi: 10.1186/1757-7241-21-62.
DOI: https://doi.org/10.1186/1757-7241-21-62
Kelman S, Friedman JN. Performance improvement and performance dysfunction: an empirical examination of distortionary impacts of the emergency room wait-time target in the English National Health Service. JPART 2009, 19(4):917–946. https://doi.org/10.1093/jopart/mun028
DOI: https://doi.org/10.1093/jopart/mun028
Quality Health Care in America, Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. 2001 National Academy Press Washington, D.C.
Beattie E, Mackway-Jones K. A Delphi study to identify performance indicators for emergency medicine. Emerg Med J. 2004 Jan;21(1):47-50.
DOI: https://doi.org/10.1136/emj.2003.001123
Schull MJ, Hatcher CM, Guttmann A, Leaver CA, Vermeulen M, Rowe BH, Anderson GM, Zwarenstein M. Development of a Consensus on Evidence-Based Quality of Care Indicators for Canadian Emergency Departments. ICES Investigative Report. Toronto: Institute for Clinical Evaluative Sciences; 2010.
Wakai A, O'Sullivan R, Staunton P, Walsh C, Hickey F, Plunkett PK. Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach. Eur J Emerg Med. 2013 Apr;20(2):109-14. doi: 10.1097/MEJ.0b013e328351e5d8]..
DOI: https://doi.org/10.1097/MEJ.0b013e328351e5d8
Madsen MM, Eiset AH, Mackenhauer J, Odby A, Christiansen CF, Kurland L, Kirkegaard H. Selection of quality indicators for hospital-based emergency care in Denmark, informed by a modified-Delphi process. Scand J Trauma Resusc Emerg Med. 2016 Feb 3;24:11. doi: 10.1186/s13049-016-0203-x.
DOI: https://doi.org/10.1186/s13049-016-0203-x
Murphy A, Wakai A, Walsh C, Cummins F, O'Sullivan R. Development of key performance indicators for prehospital emergency care. Emerg Med J. 2016 Apr;33(4):286-92. doi: 10.1136/emermed-2015-204793
DOI: https://doi.org/10.1136/emermed-2015-204793
Haugland H, Rehn M, Klepstad P, Krüger A; EQUIPE-collaboration group. Developing quality indicators for physician-staffed emergency medical services: a consensus process. Scand J Trauma Resusc Emerg Med. 2017 Feb 15;25(1):14. doi: 10.1186/s13049-017-0362-4.
DOI: https://doi.org/10.1186/s13049-017-0362-4
Hsu CC, Stanford B. The Delphi Technique: Making Sense Of Consensus. Practical Assessment Research & Evaluation. 2007; 12: 1-8.
Jones P, Shepherd M, Wells S, Le Fevre J, Ameratunga S. Review article: what makes a good healthcare quality indicator? A systematic review and validation study. Emerg Med Australas. 2014 Apr;26(2):113-24. doi: 10.1111/1742-6723.12195.
DOI: https://doi.org/10.1111/1742-6723.12195
Madsen M, Kiuru S, Castrèn M, Kurland L. The level of evidence for emergency department performance indicators: systematic review. Eur J Emerg Med. 2015 Oct;22(5):298-305. doi: 10.1097/MEJ.0000000000000279.
DOI: https://doi.org/10.1097/MEJ.0000000000000279
Howick J, Phillips B, Ball C, Sackett D, Badenoch D. Oxford centre for evidence-based medicine levels of evidence. Oxford: University of Oxford; 2009.
Parkinson JE. Throwing good money after bad: should research into Emergency Department performance indicators be prioritized? Eur J Emerg Med. 2016 Oct;23(5):395-6. doi: 10.1097/MEJ.0000000000000348.
DOI: https://doi.org/10.1097/MEJ.0000000000000348
Mohammadi E, et al. Emergency department performance evaluation indicators in pre and post-health care reform in Kermanshah public hospitals. Research Journal of medical Sciences 2016;10:54-59.
Cohen K, Bruijns S. Describing key performance indicators for waiting times in emergency centres in the Western Cape Province, South Africa, between 2013 and 2014. S Afr Med J. 2018 Jun 26;108(7):579-584. doi: 10.7196/SAMJ.2018.v108i7.12969.
DOI: https://doi.org/10.7196/SAMJ.2018.v108i7.12969
Van Buuren M, Jan Kommer G, Rob van der Mei R, Bhulai S. EMS call center models with and without function differentiation: A comparison. Operations Research for Health Care 2017; 12:16–28
DOI: https://doi.org/10.1016/j.orhc.2016.12.001
Montassier E, Labady J, Andre A, Potel G, Berthier F, Jenvrin J, et al. The effect of work shift configurations on emergency medical dispatch center response. Prehosp Emerg Care 2015; 19:254–259.
DOI: https://doi.org/10.3109/10903127.2014.959217
Penverne Y, Leclere B, Labady J, Berthier F, Jenvrin J, Javaudin F, Batard E, Montassier E. Key performance indicators' assessment to develop best practices in an Emergency Medical Communication Centre. Eur J Emerg Med. 2018 Oct;25(5):335-340. doi: 10.1097/MEJ.0000000000000468.
DOI: https://doi.org/10.1097/MEJ.0000000000000468
Regione autonoma Friuli Venezia Giulia. Piano dell’Emergenza Urgenza della Regione Friuli Venezia Giulia. Available at http://mtom.regione.fvg.it/storage//2015_1674/Allegato%201%20alla%20Delibera%201674-2015.pdf. Accessed June 20, 2019.
Agenzia Nazionale per I Servizi Sanitari Regionali. Programma nazionale Esiti 2018. Available from https://pne.agenas.it/emur/default_emur.php
Laboratorio MeS - Istituto di Management Scuola Superiore Sant'Anna. Il sistema di valutazione della performance dei sistemi sanitari regionali. Available from http://performance.sssup.it/netval/start.php
Crilly J, Bost N, Thalib L, Timms J, Gleeson H. Patients who present to the emergency department and leave without being seen: prevalence, predictors and outcomes. Eur J Emerg Med. 2013 Aug;20(4):248-55. doi: 10.1097/MEJ.0b013e328356fa0e.
DOI: https://doi.org/10.1097/MEJ.0b013e328356fa0e
Trauma Services BC. 2017-18 Annual Report. http://www.phsa.ca/our-services-site/Documents/TSBC_Annual%20Report_2017-18.pdf
Valent F, Deroma L, Cocconi R, Picierno A, Sartor A. Hospital discharge diagnoses in patients with positive blood cultures in an Italian academic hospital. Ann Ist Super Sanita. 2019 Jan-Mar;55(1):19-25. doi: 10.4415/ANN_19_01_05.
Di Chiara A, Clagnan E, Valent F. Epidemiology and mortality in an Italian region after the adoption of the universal definition of myocardial infarction. J Cardiovasc Med (Hagerstown). 2020 Jan;21(1):34-39. doi: 10.2459/JCM.0000000000000893.
DOI: https://doi.org/10.2459/JCM.0000000000000893
Ministero della Salute. Servizio Sanitario Nazionale: I LEA. http://www.salute.gov.it/portale/lea/dettaglioContenutiLea.jsp?lingua=italiano&id=1300&area=Lea&menu=leaEssn.
How to Cite
Valent, F., Di Chiara, A., & Di Bartolomeo, S. (2020). Emergency Key Performance Indicators in the Italian region Friuli Venezia Giulia. Emergency Care Journal, 16(2). https://doi.org/10.4081/ecj.2020.8910
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
