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8 December 2017

What role does performance information play in securing improvement in healthcare? A conceptual framework for levers of change.




Across healthcare systems, there is consensus about the need for independent and impartial assessment of performance. There is less agreement about how the measurement and reporting of performance actually improves healthcare. This webinar will discuss a recently published paper that introduces a conceptual framework that describes ways in which change can be leveraged by healthcare performance information (Levesque and Sutherland, 2017). The framework identifies eight levers for change enabled by performance information, spanning internal and external drivers, and emergent and planned processes: (1) cognitive levers provide awareness and understanding; (2) mimetic levers inform about the performance of others to encourage emulation; (3) supportive levers provide facilitation, implementation tools or models of care to actively support change; (4) formative levers develop capabilities and skills through teaching, mentoring and feedback; (5) normative levers set performance against guidelines, standards, certification and accreditation processes; (6) coercive levers use policies, regulations incentives and disincentives to force change; (7) structural levers modify the physical environment or professional cultures and routines; (8) competitive levers attract patients or funders.



Dr Levesque, Chief Executive of the NSW Agency for Clinical Innovation (ACI).

Dr Jean-Frédéric Levesque joined the NSW Agency for Clinical Innovation (ACI) as Chief Executive in June 2017. Prior to this he was the Chief Executive of the Bureau of Health Information (BHI) from 2013. Dr Levesque has previously held senior positions responsible for publicly reporting information about the Canadian health system. These included the role of Scientific Director, Analyses and Evaluation of Health Systems at the Institut National de Santé Publique du Québec and Deputy Commissioner, Performance Appraisal and Analysis, at the Commissaire a la santé et au bien-etre du Québec. He is currently a member of the Strategic Analytic Advisory Committee of the Canadian Institute of Health Information. Dr Levesque is a Conjoint Professor at the Centre for Primary Health Care and Equity of the University of New South Wales. His research focuses on healthcare performance, particularly in terms of how different models of care impact on patient outcomes and experiences of care, and on the analysis of healthcare reform. In 2011-12, he was a Visiting Academic at the University of Melbourne. He is a Fellow of the Royal College of Physicians of Canada in Preventive Medicine and Public Health and has a Doctorate in Public Health, a Masters in Community Health and a medical degree from the Université de Montréal, Canada.



Kim Sutherland – Acting Chief Executive, Bureau of Health Information

Kim Sutherland joined the Bureau of Health Information in 2010 and was appointed Acting Chief Executive in May 2017. Her substantive position is Senior Director, Performance Measurement and Reporting.  Kim is a health services researcher with experience in performance measurement and reporting, evaluation and assessment of quality, change management in healthcare organisations, and the diffusion of innovations. She has played a central role in the development of performance measurement frameworks in healthcare systems in the United Kingdom and in NSW. She was co-author on a series of reports evaluating the English National Health Service 10-year quality agenda and this work continues to act as the conceptual base for the joint Health Foundation - Nuffield Trust QualityWatch initiative, based in London. Kim currently sits on a healthcare quality indicator technical advisory group of the Organisation for Economic Cooperation and Development.While at BHI, Kim has led project-based teams to produce over 40 peer reviewed reports that span a range of different patient groups, methodological approaches and organisational contexts to provide a comprehensive picture of performance in the NSW healthcare system.  Kim has a Bachelor of Science degree from the University of Technology, Sydney; a Master of Science from London Hospital Medical College; a Master of Business Administration from Imperial College, London; and a Doctorate from the University of Cambridge.