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HIQA Guidance on Key Performance Indicators to Monitor Quality of Healthcare

DATE: 23.06.2011


In September 2010 the Health Information and Quality Authority (“HIQA”) issued a new guidance note entitled Guidance on Developing Key Performance Indicators and Minimum Data Sets to Monitor Healthcare Quality. Its purpose is to assist healthcare providers to develop appropriate Key Performance Indicators (“KPIs”), in monitoring and improving the quality of service provided to patients.

KPIs are performance monitoring tools that can be used to identify where performance is meeting desired standards and where it is falling short. KPIs can also be used to provide accountability to service users and governing bodies, by allowing for inter-organisational comparisons, which can facilitate decisions in relation to resource allocation.

The Guidance defines KPIs as ‘specific and measurable elements of health and social care’ and outlines how healthcare providers can develop them for use on a local and national basis to address the increased public focus on the quality of healthcare services.

Good quality information is vital in performance monitoring and the use of KPIs can aid in the procurement of such information by grounding a systematic approach to data collection. However, KPIs need to be clearly defined if the data collected is to maintain a high level of quality and in order to enhance the validity and reliability of the KPls.

The Guidance proposes six key criteria for the creation of a KPI:

  1. Identify the audience and the use intended for the KPIs. The audience is the group or person whom the KPI will assist, and might be the service-user, clinician, general public, facility or the healthcare system. The use of the KPI might centre on safety, effectiveness, efficiency, the individual or equity, and can range from internal use to enable an improvement in service, to an external comparison of the standard of an organisation against a similar body.
  2. Consult with stakeholders and the advisory group throughout the development process. This facilitates the identification of stakeholders’ needs and contributes to the acceptance of KPIs. As the most important stakeholder in healthcare, the service user requires special consideration in this process but consultations should also be undertaken with relevant health professionals.
  • Balance the process of data analysis through consideration of the needs of the service user and internal management, the need for continuous improvement, and financial considerations.
  • Determine selection criteria, as to which KPIs will be used, based on the views and consensus of experts and potential users.
  • Finally, define the KPIs and identify the rationale for assessing performance to provide context and highlight the importance of the subject being measured.


In line with the increased public awareness of the quality of health care services provided by organisations and individuals, HIQA intends that use of KPIs will assist health service providers in monitoring and improving the quality of service provided to service users.


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