Identification of Key Performance Indicators for a Tertiary Hospital using Delphi Technique

Abstract

Background: Performance indicators are critical tools for assessing and evaluating the operational and strategic effectiveness of an organization. A carefully selected set of performance indicators not only enhances the accuracy of evaluation but also significantly influences the quality of services delivered. The selection of appropriate performance indicators is a complex process that requires methodological rigor to ensure relevance, reliability, and validity. Among the various consensus-building techniques, the Delphi method is widely recognized for its effectiveness in facilitating expert agreement on indicator selection. This study aims to identify the actionable performance indicators for organizational performance measurement using the Delphi technique by engaging a panel of experts through multiple rounds of surveys and feedback

Methods: A group of eight experts representing various organizational levels and experiences participated in a Two-round Delphi study to identify the most actionable indicators. The indicators were initially identified through a scoping review of existing literature and in-depth interviews with stakeholders. In the first round, the experts assessed indicators’ importance and data collection feasibility using 7-point Likert scale. In the second round, they assessed the indicators’ implementation using Yes/no scale.

Results: A primary list of 80 potential indicators covering different 13 domain and considering Donabedian’s framework was generated. Of these, 12.5% focused on structural aspects, 42.5% on processes, and 45% on outputs/outcomes.  After the first round, 50 indicators were selected based on their scores. After the second round, consensus reached with 31 indicators were selected to be implemented. This final list covered 8 domains with focus on for medication management (9 Indicators) and patient safety (6 indicators).  

Conclusion: Reaching consensus is a fundamental step for selection of action indicators. The Delphi technique is an appropriate tool to reach consensus on selection of quality indicators at healthcare setting.

Highlights:

Delphi technique to reach consensus about performance indicators applied in a tertiary hospital.