1.

Glossary of indicators
2. Types of indicators
3. List of indicators
4. Purpose of indicators
5. Target

 All patients admitted to

the hospital for more
than 24 hour through
emergency or outpatient
clinics
Excluding:
Patients admitted less
than 24 hours
Patients admitted directly
to ICUs.

 All patient visited the

outpatient clinics
through a certain
period of time
Whether admitted or
discharged.

 All deaths in inpatient departments including those

inpatients who were transferred to ICU within 48
hours before death.

Excluding :
Mortality of patients who were directly admitted to
ICU.
Inpatients deaths that stays in icu>48 hours
Deaths in emergency
Inpatient deaths in less than 24 hours

 Total Number of discharged patients

(including the deaths)
This definition is applicable for any discharge
like inpatient, ICUs, NICU,

 is clinically evident infections that do not

originate from patient original admitting
diagnosis and
become clinically evident after 48 hours of
hospitalization.
(all patient received inpatient service and
acquired infection (by episode)after 48 hours
of hospitalization)

 one single site of infection in the same patient

 Patients discharged to home care or self care and

readmitted within 30 days for
Same medical reason that prompted the original
hospitalization
Excluding:
Patients discharged against medical advice
Patients discharged/transferred to another
facility for inpatient care

 Patients who died in each clinical department

separately during their stay for more than 24
hours
Excluding:
- ICUs deaths and inpatient deaths less than
24hours

 Summation of daily inpatient census over the

period of stay
Inpatient days of care in ICU,CCU&NICU (
summation of daily ICUs patients census over
the period of stay ).

total
number of Beds available in inpatient .
: total number of
Beds available in ICUs

 All deaths in ICUs (medical coronary& surgical)

Including those inpatients who were transferred to ICU for
more than 48 hours before death and patients admitted
directly to ICUs.

Excluding:
-Inpatients deaths that stays in ICU less than 48
hours
-Patients admitted directly to ICU and died within
24 hours

 All day cases deaths in all departments anddeaths within 24 hours in all departments
Excluding:
- Inpatient deaths who were admitted and
stayed more than 24 hour.
-

 Cases admitted for less than 24 hours services

whether for surgical or medical reasons.

 All deaths in NICU departments including

those inpatients who were transferred to
NICU for more
than 48 hours before death and patients
admitted directly to NICUs. Excluding:
-Patients admitted directly to NICU and died
within 24 hours

 It includes
Superficial surgical site infection,
Deep surgical wound infection
Organ/space surgical site infection

 Infection occurs within 30 days after surgery and involves only

skin and subcutaneous tissue of the incision and any of the
following:
Purulent drainage from the superficial incision.
Organism isolated from an aseptically obtained culture of fluid
or tissue from superficial incision.
Surgeon deliberately opens wound because of pain or
tenderness, localized swelling, redness or heat, unless wound
is culture -negative.
Surgeon's or attending physician's diagnosis of superficial
incisional infection.

 Infection occurs within 30 days after surgery if no implant is

left in place or within 1 year if implant is in place and infection
appears related to surgery,
infection involves deep, soft tissues and any of the following:
Purulent drainage
A deep incision spontaneously dehisces or is deliberately
opened by surgeon
An abscess or other evidence of infection involving deep
incision
Surgeon's or attending physician's diagnosis of infection.

 Infection occurs within 30 days after surgery if no implant is

left in place or within 1 year if implant is in place and infection
appears related to surgery
infection involves any part of the body excluding the skin
incision, fascia or
muscle layers, and any of the following:
Purulent drainage from drain
Organism isolated from aseptically obtained culture of fluid
An abscess or other evidence of infection
Surgeon's or attending physician's diagnosis of infection.

1. Structure,
2. Process, and
3. Outcome

 Good structure leads to good process

and good process leads to a good
outcome
When we understand the relationship
between process and outcome, well
often favour measuring process,
remembering of course that it is always
outcome that were interested in

denotes the attributes of the

settings in which care occurs.
Includes:
Material resources: facilities,

financing.

Human resources: number

of personnel.

equipment, and

and qualifications

Organizational structure: medical

staff,
organization, methods of peer review,
and methods of reimbursement.

 Structure refers to health system characteristics that

affect the systems ability to meet the health care
needs of individual patients or a community.
Structural indicators describe the type and amount of
resources used by a health system or organization to
deliver programs and services, and they relate to the
presence or number of staff, clients, money, beds,
supplies, and buildings.

 Proportion of specialists to other doctors

Access to specific technologies (e.g. MRI
scan)
Access of specific units (e.g. stroke units)
Clinical guidelines revised every 2nd year
Physiotherapists assigned to specific units

 Process indicators assess what the provider did

for the patient and how well it was done.
Processes are a series of inter-related activities
undertaken to achieve objectives.
Process indicators measure the activities and
tasks in patient episodes of care.

 Proportion of patients with diabetes given

regular foot care
Proportion of patients with myocardial
infarction who received thrombolyses
Proportion of patients assessed by a doctor
within 24 hours of referral
Proportion of patients treated according to
clinical guidelines

 HbA1c results for diabetics

Lipid profile results for patients with hyperlipidemia
Blood pressure results for hypertensive patients
(should be specified for diseases)
Mortality
Morbidity
Functional status
Health status measurement
Work status
Quality of life
Patient satisfaction

 Dont use information generated at the grass

roots against the interests of those at the
grass roots
Promote the use of performance indicators
when you are confident that they are valid
and can be collected reliably

Take care in the use of smiley faces and sad

faces- remember they are part of managerial
(& political) discourse, not professional
discourse