The Health Information and Quality Authority (HIQA) is an independent Irish authority established to monitor and improve the quality and safety of the health and social care services in Ireland. HIQA’s role is to develop standards, inspect and review health and social care services and support informed decisions on how services are delivered.
When CEO Phelim Quinn was appointed he wanted to put in place a more robust strategic performance management system. With buy-in from his senior management team and the board the goal was to create more strategic clarity by mapping the strategic goals onto a single page map and then develop relevant and meaningful performance indicators that would allow HIQA to monitor its performance and impact.
I was appointed to help HIQA develop this strategic performance management framework.
We started the project by conducting individual one-to-one interviews with board members, executive directors, senior managers as well as many external key stakeholders. The interview data allowed me to draft a first version of the strategy map, which we then refined in a number of working group sessions with the executive team.
You can see the current one-page strategy map for HIQA in the figure below.
Extensive Engagement & Consultation
Once the initial draft map was agreed, HIQA conducted a comprehensive process of staff and stakeholder engagement. This included an online survey and an internal staff survey. In addition, the working group further engaged with the board members of HIQA individually and collectively, HIQA’s executive management team, HIQA’s staff and representatives of the Department of Health, Department of Children and Youth Affairs, the Child and Family agency (TUSLA) and the Health Service Executive.Following this, HIQA’s strategy map was further refined thanks to feedback received during a public consultation process.
The HIQA strategy map
HIQA has been able to distil its strategy into a simple and focused framework of strategic objectives across a three main layers: the core outcomes the organisation is aiming to achieve, the core activities the organisation must excel at, as well as the underpinning enablers that are vital for the deliver of the strategy.
The corporate mission
At the top of the map sits HIQA’s mission of:
HIQA is an independent authority that exists to improve health and social care services for the people of Ireland
What HIQA aims to achieve
The first layer identifies the outcome deliverables. Here HIQA focuses on four core outcomes for people using health and social care services which are:
These outcomes embody the reason why HIQA exists and importantly, what HIQA aims to achieve over the life of its current corporate plan.
What HIQA has to be best at
HIQA has identifiedfive core activities (the things it has be be best at) in order to deliver its outcome. These are:
The underpinning enablers of success
Finally, HIQA identified the key enablers of success, the resources and processes that need to be in place and managed well in order to be able to perform well. HIQA identified the following five enablers:
Establishing clear targets
Once the strategy was mapped and agreed, the process began to set clear targets. For each of the strategic goals on the strategy map, HIQA identified some short term targets as well as 3 year targets to illustrate what successful performance will look like.
Take the example of the core activity ‘Assess health technologies’, with is defined as
“HIQA independently assesses the clinical effectiveness and cost-effectiveness of health technologies.”
To show what performance will look like, the organisation has defined the following targets:
Over the next three years, HIQA will:
• produce high-quality health technology assessments (HTAs) targeted to inform major health policy and health service decisions
• continue to build capacity to conduct and use HTA across the health system. By December 2018 HIQA will have:
• conducted high quality effective HTAs prioritised to add maximum value to healthcare decision making
• maximised productivity by leveraging HTA work conducted elsewhere
• developed and revised HTA guidelines as appropriate to promote production of high quality HTA across the system
• provided technical expertise to support the work of the National Clinical Effectiveness Committee
• supported the development of national HTA capacity through education, training and research activities.
Developing Key Performance Indicators
In order to monitor and manage the delivery of their strategic goals, the HIQA requires performance metrics. To identify the most relevant and meaningful measures, we first developed Key Performance Questions, or KPQs for short. KPQs are the questions the organisation needs to have an answer to in order to understand how well it is performing against their strategic goals. This process ensures that subsequently designed Key Performance Indicators (KPIs) are helping to answer the most important questions.
Ideas and insights you can steal
HIQA has been able to distil its strategy into a simple and focused one-page strategy mapwhich now helps everyone inside and outside of the organisation understand HIQA’skey goals and priorities. With such clarity it is a lot easier to ensure that all the key activities of the organisation are focused on delivering what really matters and it is a lot easier to monitor and measure not only HIQA’s impact but also whether it is performing well internally.
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