CRITERIA AND STANDARD
SETTING FOR INDICATORS
DR ZAHARIMAH ABDUL KADIR
HOSPITAL TUANKU JA’AFAR
SEREMBAN
INDICATOR
• Indicator of obesity – BMI (weight, height )
• Indicator of time - time on the clock
• Indicator of direction - North,
INDICATOR AND STANDARD
Standard Indicator
• Measurement of good care • An objectively defined
through one or more indicators measure of quality
• An agreed upon level of • A measurable variable (data)
excellence; an established relating to structure, process or
norm outcome
• Acceptable lowest limit • Usually expressed in the form
• The achievable target of rates (%)
considered to indicate quality
• Line dividing good from poor
quality
• Verify problem exist
STANDARD OF CARE FOR DIABETIC PATIENTS: ALL DM
PATIENTS MUST BE PROVIDED WITH QUALITY EYE CARE
Standard: Indicator:
• All Diabetic patients • Percentage of the
must have dilated diabetic population
fundus examination at receiving a dilated
least once a year eye examination in
the past year
MEASURING STANDARD
• Using threshold
The value on a yardstick that mark the line of acceptable
performance or results.
It measures/assess the indicator
ie: if the threshold is 90% :
The quality of care at a centre is said to be acceptable if
90% or more of the diabetics had at least one dilated eye
examination in the past one year
SETTING STANDARD
• Based on international or local norms
• Literature search
• Other studies
• By measuring average from previous data
TYPES OF STANDARDS
• Accreditation standard
• Practice guidelines
Statements by experts that describe recommended or
suggested procedure
• Protocols
A more precise and detailed plan for a process
• SOP
A statement of the expected ways in which an
organization’s staff carries out certain activities
• Specification
A detailed description of the characteristics or
measurements for a product, service or outcome
CLINICAL INDICATOR
• An instrument (data) used to assess a measurable
aspect of patient care or healthcare.
• Acts as a guide to assess the performance of a hospital,
department or individuals within it.
• Reflects the quality of service that is measured
• Can be assessed objectively using certain criteria
• Can differentiate between the ones with quality from
those without
CHOOSING INDICATORS
• Should directly address the problem
• Measurable
• Derived from standard
• Based on available data or easy to collect
• May be done indirectly via data of effects of the problem
CHOOSING INDICATORS
i. Identify a function/system that require monitoring
ii. Identify elements in the system such as input (human
resources), processes (tasks), output (mortality rate,
intubation rate, cancer detection rate)
iii. Identify quality characteristics of each elements (availability,
accessibility)
iv. State the standard
v. Develop the indicator
vi. Define the threshold
vii. Assess the appropriateness of the standards
INDICATORS
• Intubation rate of newborn <24 hours of life
• Length of NICU stay
• % of patient with waiting time < 2 weeks for endoscopy
appointment from first presentation to
ETD/OPD/Specialist clinic
• Rate of early cancer detection
CRITERIA
• Condition to fulfill to define an indicator
• Can be used to define the sample limits
• Decided by peer decision or consensus
• May be implicit or explicit
2 types - included as sample
Inclusion criteria - not included as sample
Exclusion criteria
INCLUSION AND EXCLUSION
CRITERIA
Inclusion Exclusion criteria
Neonates who require Babies who do not
assisted ventilation for require assisted
the management of ventilation at birth
respiratory distress at Newborn with major
birth congenital anomalies
No major congenital
anomalies
THANK YOU