Applying Qualitative System Dynamics to Enhance Performance Measurement for a Sustainable Health System in British Columbia




Yang, Qi William

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The current approach to performance measurement in British Columbia is to select and match performance measures with strategic goals and objectives so that health administrators and decision makers can evaluate the performance of different care sectors (e.g. primary, community and acute care) within the provincial health system. Although this approach offers basic understanding of system performance, it is static and considers the performance of organizational components in isolation from their interrelationships and external influences. The purpose of this research is to enhance the current performance measurement approach in BC by linking health system variables through causal relationships and feedback loops that can impact and lead to health system sustainability. The qualitative system dynamics method was applied to develop a conceptual performance measurement model. Fifteen interviews with stakeholders were conducted at the BC Ministry of Health to validate and improve the pre-validation model. A post-validation model was then created based on the feedback and comments from the 15 interview participants. As a product of this research, the post-validation model, Web of Measures 2.0, will explain how the identified cause and feedback mechanisms both internal and external to the BC health system may help determine policy levers for designing and developing quality improvement initiatives. Although quantitative analysis is out of scope for this research, potential benefits of inputting BC data into the proposed model are discussed at the end of this thesis.



Health system performance measurement, Health system sustainability, Qualitative system dynamics, System modeling