Clinical update: DHB System Level Measures Summary

Published: 11 August 2017

The DHB System Level Measures Framework (SLM) is starting to have a significant impact on how DHBs are planning and orienting their services and quality improvement initiatives.

There are six SLMs including:

• Ambulatory Sensitive Hospitalisation (ASH) rates for 0–4 year olds (that is, keeping children out of hospital)
• Acute hospital bed days per capita (that is, using health resources effectively)
• Patient experience of care (that is, person-centred care)
• Amenable mortality rates (that is, prevention and early detection)
• Proportion of babies who live in a smoke-free household at six weeks post natal (that is, a healthy start)
• Youth SLM (that is, youth are healthy, safe and supported).

Under each of these are a range of contributory measures. CVD features mostly in the Amenable Mortality and Acute Hospital Bed Days SLMs. Now that there is no national CVD Health Target, these are the measures which will drive activity to improve CVD management.

The good news is DHB SLMs include CVD contributory measures but the anecdotal feedback to date suggests the impact at the frontline to date is very mixed. A highlight in these SLMs is the Auckland DHB Alliance (CMDHB, ADHB, WDHB) decision to target “increasing the % patients with a prior CVD event receiving triple therapy and the % patients at high risk >20% receiving dual therapy”. The 2016 baseline numbers are triple therapy 55% & dual therapy 45%, illustrating the magnitude of the gap in management which exists. 

Based on a review of the DHB/PHO SLM improvement plans available online in June 2017 the slides below summarise the CVD contributory measures by DHB. 

Download the slides

Tony Peck

Clinical Support Manager - Heart Healthcare

I lead the team who support health professionals to provide better care for people with heart disease or at high risk. With many years working in the pharmaceutical industry he aims to bring everything back to improving patient outcomes.