Games People Play: Lessons on Performance Measure Gaming from New Zealand; Comment on “Gaming New Zealand’s Emergency Department Target: How and Why Did It Vary Over Time and Between Organisations?”

Document Type: Commentary

Author

1 Center for Advanced Methods Development, RTI International, Durham, NC, USA

2 Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

Abstract

For decades, observers have noted that gaming of performance measurement appears to be both endemic and endlessly creative. A recent study by Tenbensel and colleagues provides a detailed look at gaming of a health system performance measure—emergency department (ED) wait time —within four hospitals in New Zealand. Combined, these four hospitals handled more than 25% of the ED visits in the country each year. Tenbensel and colleagues examine whether the New Zealand ED wait time target was set appropriately and whether we can trust any performance measure statistics that are not independently verified or audited. Their thought-provoking examination is relevant to anyone working in quality improvement and provides a valuable set of tools for detecting gaming in performance measurement.

Keywords


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