Appendix 9 Key Performance Indicators for Homecare Service Providers
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1 Appendix 9 Key Performance Indicators for Homecare Service Providers These KPIs are currently under review by the National Homecare Medicines Committee and a final version of agreed KPIs is anticipated to be available in October Glossary of terms 'KPI' Key Performance Indicator. 'Field' Single item of requested data within the KPI report. 'Homecare provider' External organisation responsible for dispensing medicines/treatments to patients of the health board/trust. 'Health board/trust' The health board/trust to which the service is provided. 'Therapy area' The therapy area to which the service is provided, e.g. HIV, rheumatology, virology etc. 'Out of schedule delivery' Any delivery required to a patient which is not their scheduled delivery. Reasons for out of schedule deliveries may include missed items, errors, deliveries to incorrect address etc. 'Ancillary item' An item that is delivered with medicines to supplement the usage of the medicine (sharps bins, needles, wipes, giving sets etc.). 1.0 Purpose 1.1 To describe in detail the format of the KPI reports required from the homecare providers and what each field means. 2.0 Scope 2.1 KPI reports will be provided by the homecare providers in the format shown on a month by month basis. 2.2 Reports will be made available to the health board/trust at the end of each financial quarter (January, April, July and October). 2.3 A report will be available for each therapy area within the contract. 2.4 For AWDCC contracts, KPI reports will be provided for the entire country by therapy area. 2.5 Individual purchasing authorities will have the option to request local KPI reports using the same format. 3.0 Responsibility 3.1 Collation of KPIs will be the responsibility of the appropriate persons within the homecare provider's operational structure. 3.2 KPIs will be analysed by the health board/trust and discussed with the appropriate clinical staff by therapy area. Page 1 of 7
2 4.0 Equipment 4.1 Standard KPI report template. 5.0 Procedure 5.1 Completion of KPI fields: Total number of patients registered (active) the number of patients who are registered as active, irrespective of whether a delivery has been due that month. should reflect the number of patients who have received treatment that month Number of newly registered patients the number of new patients registered that month. should be marked not applicable (N/A) Number of patients 'off treatment' the number of patients who have finished treatment or had treatment cancelled. should be marked N/A Number of patients 'on hold' the number of patients who are currently suspended from receiving treatment but are expected to resume treatment at some point. should be marked N/A Number of deliveries made This field should reflect the actual number of deliveries made that month and will cover all modes of delivery (company van, special delivery, courier etc.). This will also include any out of schedule deliveries required for any reason Total number of items issued An 'item' can be described as a single dispensing event, e.g. A homecare prescription for 28 tobramycin 160 mg and 14 ceftazidime 1000 mg across one delivery would be two items (if they are dispensed in one batch). If batch is split over two dispensing episodes, there would be two items per batch. A homecare prescription for 24 methotrexate syringes issued as two deliveries of 12 syringes would be two items. Page 2 of 7
3 5.1.7 Number of medicine errors (external) The total number of medicine errors that have been issued by the homecare provider and arrived with the patient, irrespective of whether the error was identified before the patient actually took/administered the incorrect treatment. A medicine error can be defined as an episode where any one or more of the following have occurred: Incorrect medicine Incorrect strength Incorrect formulation Incorrect dose Incorrect quantity Incorrect directions Incorrect route of administration Incorrect label details Omitted medicines Medicine expired Medicine unfit for purpose Number of service failures The total number of incidents per month where the expected level of service has not been reached but does not include medicine errors. Examples of service failures which are not medicine errors include but are not limited to: Missed deliveries Late deliveries Missing ancillary items Communication failures Patient complaints Pump/equipment/device failures Number of incidents 'for information only' The total number of incidents per month that have been sent through to the clinical team for notification purposes, e.g. concerns regarding patient compliance, failures to contact patients, stock shortages due to supply issues etc Number of invoices Total number of invoices sent out for payment per month Total monthly spend Total amount of invoiced spend by the health board/trust per month for the specified therapy area. Spend will include medicine costs, delivery charges and VAT (where applicable). Delivery service analysis Deliveries outside 'two hour window' Total number of deliveries per month that do not arrive within the stated two hour window given to patients. Delivery is classified as 'failed' if the delivery window is altered by the homecare provider on the day of the delivery even if the patient agrees that the new delivery window is convenient. Page 3 of 7
4 Medicine errors by category Incorrect medicine Medicine supplied is incorrect against the tendered prescription Incorrect dose Dose supplied is incorrect against the tendered prescription Incorrect label details The information on the label is incorrect (medicine name/directions/dose/quantity/ formulation/additional directions/patient name) but the rest of the dispensing is correct Incorrect formulation The formulation of the medicine is incorrect even though the medicine may be correct e.g. capsules instead of tablets, plain instead of modified release, solid dose form instead of liquid and incorrect route of administration Omitted medicines Delivery is missing an item of medication that was expected with the delivery Incorrect quantity Amount supplied does not match the amount requested on the tendered prescription. In the case of product shortages, the event shall be classified as an incident where there has been no provision to cover the shortfall before becoming due and there has been no effort to contact the relevant clinical team to notify of the shortage Medicine expired/unfit for purpose Medicine has been issued to the patient that has either expired or will expire before the patient can complete the prescribed amount within the expected period of treatment. Unfit for purpose defines any medicine received by a patient that cannot be used due to damage or defect Medicine errors as a percentage of total items issued Displays the sum of the medicine errors by month divided by the total number of items issued that month and multiplied by 100 to give a percentage figure of errors. Service failure by category All 'service failures' that are as a result of an error by health board/trust staff or patient error should not be counted in any category other than 'health board/trust error' or 'patient error' Missed/late deliveries Total of all deliveries that, for whatever reason, are missed or do not arrive on the expected day of delivery. This does not cover deliveries that are outside the two hour window unless, as a result of missing the two hour window, the delivery has to be scheduled for another day Delivery to wrong location Deliveries that are supplied to any location other than the location expected by the patient for that delivery Missing/incorrect ancillary item Deliveries that contain an ancillary item that is incorrect or deliveries that are missing an expected ancillary item Ancillary item faulty Delivered ancillary item is not fit for purpose Pump/equipment/device error There has been a fault/defect on a supplied item of equipment or device that has resulted in the patient having to contact the homecare provider. Page 4 of 7
5 Health board/trust error An error by the clinical team at the health board/trust has resulted in a service failure Patient error An error by the patient has resulted in a service failure e.g. requesting incorrect ancillaries, being out when delivery due, providing incorrect contact details etc Prescription unavailable/late prescription request Deliveries have been delayed due to homecare provider not having a valid prescription because they failed to request a new prescription in sufficient time (only applies to services where a prescription management service is offered and accepted by health board/trust) Other (please specify below) Any other service failure that is not covered by the above fields. The homecare provider is requested to enter a brief summary of the incident as a comment in the 'other' box Service failures as a percentage of total number of deliveries Displays the sum of the service failures by month divided by the total number of items delivered that month and multiplied by 100 to give a percentage figure of errors. Invoicing errors by category Number of credit notes issued The number of credit notes sent to the health board/trust per month to rectify anomalies on previously tendered invoices Incorrect account The number of credit notes raised due to the incorrect account being billed by the homecare provider Incorrect product The number of credit notes raised due to incorrect products being billed for by the homecare provider Incorrect price The number of credit notes raised due to incorrect price being billed by the homecare provider Incorrect quantity The number of credit notes raised due to incorrect quantity being billed for by the homecare provider Incorrect VAT status The number of credit notes raised due to the incorrect VAT status being applied to the original invoice Performance Displays the sum of the total number of credit notes divided by the total number of invoices issued that month and multiplied by 100 to give a percentage figure of errors. 5.2 Frequency of KPI reports Homecare providers shall make the reports available at the end of each financial quarter Separate reports will be available for: Wales as a whole (where provision of service is by regional contract) Wales 'by therapy area' (where provision of service is by regional contract) For each therapy area within the health board/trust (subject to individual request by local purchasing authority) Page 5 of 7
6 Key Performance Indicator reports by homecare providers Treatment area Month Average Total Total number of patients registered (active) ######## NA Number of newly registered patients NA 0 Number of patients off treatment NA 0 Number of patients 'on hold' NA NA Number of deliveries made ######## 0 Total number of items issued ######## 0 Number of medicine errors (external) NA 0 Number of service failures NA 0 Number of incidents 'for information only' NA 0 Number of invoices ######## 0 Total monthly spend ######## 0.00 Delivery service analysis Deliveries outside 2-hour window #DIV/0! 0 Performance % #DIV/0! NA Medicine errors by category Incorrect drug NA 0 Incorrect dose NA 0 Incorrect label NA 0 Incorrect formulation NA 0 Omitted drug NA 0 Incorrect quantity NA 0 Medicine expired/unfit for purpose NA 0 Medicine errors as a % of total items issued ######## NA Service failure by category Missed/late delivery NA 0 Delivery to wrong location NA 0 Ancillary item missing/incorrect NA 0 Ancillary item faulty NA 0 Pump/equipment/device issue NA 0 Health board/trust error NA 0 Patient error NA 0 Prescription unavailable/late prescription request NA 0 *Other (please specify below) NA 0 Service failures as a % of total number of deliveries #DIV/0! NA Page 6 of 7
7 Invoicing errors by category Number of credit notes issued NA 0 Incorrect account NA 0 Incorrect product NA 0 Incorrect price NA 0 Incorrect quantity NA 0 Incorrect VAT status NA 0 Performance % #DIV/0! NA Page 7 of 7
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