The World Health Organization Performance Assessment Tool for Quality Improvement in Hospitals (PATH): An Analysis of the Pilot Implementation in 37 Hospitals

Abstract

Key to successful implementation was the embedding of PATH in existing performance measurement initiatives while acknowledging the core objective of the project as a self-improvement tool. The pilot test raised a number of organizational and methodological challenges in the design and implementation of international research on hospital performance assessment. Moreover, the process of evaluating PATH resulted in interesting learning points for other existing and newly emerging quality indicator projects.

Making performance indicators work: The experience of using consensus indicators for external assessment of health and social services at regional level in Spain

“…From a policy perspective clarifying the purpose of performance assessment and creating a facilitating environment appear to be the most important lesson. Moreover, we observed as other authors presenting experience with quality indicator projects, that the use of a care model to guide indicator selection helps involving professionals and centring discussions on identifying improvement actions [5,28,29].…”

“…While 10-15 years ago performance assessment was considered an innovative field, many projects are now operational in the US and in European countries [4] or supported by international organizations such as the World Health Organization [5] and OECD [6]. Most performance assessment initiatives so far have focused on assessing hospital services or addressing health systems goals and comparably few initiatives have addressed non-acute health and social services.…”

Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: Policy coherence and application lessons for low and middle income countries

“…Identifying influencing factors, facilitating integration with different quality initiatives, linking the BSC indicators to other mechanisms such as accreditation, or leveraging on existing policies to enable a certain system of recognition to hospitals for their efforts and participation can all contribute to the collective buy in and support. For example, the institutionalization of WHO PATH framework for hospital benchmarking with existing quality improvement projects was shown to be important for its success [5].…”

“…At the end of the pilot, personnel responsible for data collection completed an evaluation questionnaire adapted from similar initiatives [5,27,30]. It consisted of 17 questions that assessed the feasibility, reliability and validity of each indicator on an ascending scale from 1 to 5.…”

Use of comparative performance indicators in rehabilitation

“…Several studies have focused on the development of performance indicators for the purpose of conducting a comparative analysis (Arah, Westert, Hurst, & Klazinga, 2006;Brown, Baker, Closson, & Sullivan, 2012;Groene, Klazinga, Kazandjian, Lombrail, & Bartels, 2008;Nolte, 2010), but few have evaluated how these indicators were used by organizations and the factors that influenced their use.…”