What defines a high-performing healthcare system? There is no consensus, study shows

A new study, published in The Joint Commission Journal on Quality and Patient Safety, found there is no consensus among healthcare stakeholders regarding what defines a high-performing healthcare delivery system.

Researchers identified articles defining high performance with respect to a healthcare system or organization in PubMed and WorldCat databases from 2005 to 2015 and the New York Academy of Medicine Grey Literature Report from 1999 to 2016. They conducted a systematic review of 57 articles.

The review shows there is no consistent and overarching definition of what defines a high-performing healthcare system.

The articles variably defined high performance across different dimensions, such as:

•    Quality: 93 percent of articles
•    Cost: 67 percent
•    Access: 35 percent
•    Equity: 26 percent
•    Patient experience: 21 percent
•    Patient safety: 18 percent

A majority of articles used more than one dimension to define high performance (75 percent), but only five used five or more dimensions. Quality and cost proved to be the most commonly paired dimensions, with 63 percent of organizations pairing the two.

"The absence of a consistent definition of what constitutes high performance and how to measure it hinders our ability to compare and reward health care delivery systems on performance, underscoring the need to develop a consistent definition of high performance," study authors conclude.

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