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Table 2 Dimensions, sub-dimensions and indicators reported by the 6 reviews

From: Assessing hospital performance indicators. What dimensions? Evidence from an umbrella review

1st AUTHOR, YEAR DIMENSION SUBDIMENSIONa INDICATORSa
Gandjour A, 2002 [8] Process quality/efficiency   Acute miocardial infarction
Reperfusion using either thrombolytics during the first 12 h of pain onset or primary PTCA
Use of aspirin during hospitalization
Use of lidocaine during hospitalization
Use of a β-blocker (acebutolol, metoprolol, propranolol, timolol) during hospitalization
Use of an ACE inhibitor during hospitalization
Use of statin during hospitalization for total cholesterol levels ≥6 mmol/L
  Acute stroke
Chest x-ray on admission
Brain imaging
Thrombolytic therapy within 0 to 3 h of onset
Aspirin or clopidogrel or dipyridamole or ticlopidine for ischemic stroke
Anticoagulants, calcium antagonists, change in blood pressure medication, corticosteroids, gangliosides, glycerol, hemodilution, heparinoids, low–molecular-weight heparins, piracetam, standard unfractionated heparin
  Coronary artery bypass graft
Appropriateness of indication
  Percutaneous transluminal coronary angioplasty
Appropriateness of indication
  Carotid endarterectomy
Appropriateness of indication
  Acute lower back pain
Bed rest
Exercise therapy
Immediate x-ray
Other diagnostic procedures within the first 4 weeks of symptoms
Referral to another provider without specific request
  Major depressive disorders (acute episode)
Use of DSM-IV or ICD-10 criteria for diagnosis
Use of newer or older antidepressants or problem-solving treatment or interpersonal psychotherapy or nondirective counseling or cognitive behavior therapy (conducted at own office or by referral)
Duration of drug prescription (minimum of 24 weeks)
  Type 2 diabetes mellitus
Test HbA1c once every 6 months
Biennial testing of fasting serum total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol
Annual urine test for (micro-) albuminuria
Annual testing of blood pressure
Annual foot examination including testing for pain, touch, cold, vibration, ankle reflexes, and pressure
Annual foot examination including foot structure and biomechanics, vascular status, and skin integrity
Biennial eye examination by an ophthalmologist or optometrist
Patient education
Screening programs Biennial hemoccult screening for colorectal cancer at age ≥ 50 years
Sigmoidoscopy for colorectal cancer every 10 years at age ≥ 50 years
Measurement of the prostate-specific antigen (prostate cancer)
Papanicolaou smear at least every 5 years for women who are sexually active and between 30 to 60 years old (cervical cancer)
Structural quality/efficiency   Implementation of evidence-based clinical practice guidelines
(hospitals)
(unstable angina)
Implementation of evidence-based clinical practice guidelines
(physicians’ offices)
(cancer pain)
Computer alert system to prevent injury from adverse drug events (hospitals)
Antibiotic improvement intervention Structured antibiotic order forms
Academic detailing
Veillard J, 2005 [4] Clinical effectiveness and safety Appropriateness of care Cesarean section delivery
Conformity of processes of care Prophylactic antibiotic use for tracers: results of audit of appropriateness
Outcomes of care and safety processes Mortality for selected tracer conditions and procedures
Readmission for selected tracer conditions and procedures
Admission after day surgery for selected tracer procedures
Return to higher level of care (e.g. from acute to intensive care) for selected tracer conditions and procedures within 48 h
Sentinel event
Safety Staff safety Percutaneous injuries
Staff excessive weekly working time
Patient centredness Client orientation, respect for patients Average score on overall perception/satisfaction items in patient surveys
Average score on interpersonal aspect items in patient surveys
Last minute cancelled surgery
Average score on information and empowerment items in patient surveys
Average score on continuity of care items in patient surveys
Responsive governance System integration and continuity Average score on perceived continuity items in patient surveys
Public health orientation Breastfeeding at discharge
Staff orientation Perspective and recognition of individual needs Training expenditures
Health promotion and safety Expenditures on health promotion activities
Behavioural responses Absenteeism: short- term absenteeism
Absenteeism: long- term absenteeism
Efficiency Appropriateness of services Day surgery, for selected tracer procedures
Productivity Length of stay for selected tracers
Use of capacity Inventory in stock, for pharmaceuticals
Intensity of surgical theatre use
Groene I, 2008 [3] Clinical Effectiveness
Staff orientation
Responsive governance
Safety
Patient Centeredness
Efficiency
 
Copnell B, 2009 [6] Safety  
Effectiveness
Efficiency
Timeliness
Patient-centeredness
Equity
Beyan OD, 2012 [1]   Acceptability  
Accessibility  
Appropriateness  
Care environment and amenities  
Continuity  
Competence or capability  
Effectiveness  
Improving health or clinical focus  
Expenditure or cost  
Efficiency  
Equity  
Governance  
Patient centeredness or patient focus or responsiveness
Safety  
Sustainability  
Timeliness  
Utilization  
Simou E, 2014 [9] Effectiveness Inpatient mortality from selected causes (AMI, stroke, pneumonia, etc.)
Readmission rate for selected causes
Unscheduled readmission to ICU
Perioperative mortality
Perinatal mortality due to complications
Cancer patients successfully surviving surgery/chemotherapy/transplant
Safety In-hospital avoidable VTE
Hospital-acquired infections (VAP, urinary catheter associated UTI, central line associated blood stream, surgical site, infections in neonates)
Medical errors per sector (post- surgery, improper treatment, iatrogenic)
Obstetric trauma
Staff injury
Staff needle puncture incidents
Patient centeredness Patient feedback management
Pain control
Satisfaction from personnel
Explanation of procedures, treatment and discharge information
Satisfaction from hospital environment (cleanliness, quietness, privacy)
Staff orientation Staff burnout
Staff absenteeism
Staff working overtime
Satisfaction from working environment
Clearly defined responsibilities in staff
Continuous education for health professionals
Efficiency Length of stay
ICU length of stay
Hospital bed coverage
Admission/discharge rate
Cost of inpatient services per patient day
Exams ordered at the ER, per patient
Laparoscopic/open surgery rate
Single-day stay for selected surgeries
Caesarian section rate
Surgery postponed or cancelled
Utilization Patients visiting the ER department
Admissions for acute conditions
Usage of equipment/facilities
Usage of laboratory exams
Surgical Theater use
Timeliness Time needed for initial clinical examination at the ER after arrival
Time needed for admission after arrival at the ER
Time needed for selective surgical treatment
Patients leaving without being examined
Resources and capacity Permanent personnel (per discipline)
Detached personnel (per discipline)
Temporary personnel (per discipline)
Personnel educational level (per discipline)
Intra-sector nurses to physicians ratio
Computers for the personnel
Computers with Internet access
Computers with modern applications
Use of electronic medical records
Hospitals having a webpage
Telephone center
Surgical theaters
Beds per sector
Beds per room
Short-term stay beds
Space for patient baggage
Toilet in patients’ rooms
Intra-communication facilities in patients’ rooms
Oxygen facilities in patients’ rooms
Air-conditioning facilities in patients’ rooms
Telephone facilities in wards
Imaging facilities (radiography, ultrasound, CT, MRI, etc.)
ICU and HCU unit(s)
Hemodialysis facilities
Management of hospital waste
  1. aThe blank sections of the columns “subdimension” and “indicators” are due to a lack of those information in the corresponding review