System Level Measures Framework

About System Level Measures

The System Level Measures (SLMs) Framework aims to improve health outcomes for people by supporting DHBs to work in collaboration with health system partners (primary, community and hospital) using specific quality improvement measures. It provides a foundation for continuous quality improvement and system integration.

System Level Measures:

  • are outcomes focused
  • are nationally defined
  • require all parts of the health system to work together
  • focus on children, youth and vulnerable populations
  • connect to local clinically led quality improvement activities and contributory measures.

Contributory measures:

  • assist in the achievement of the System Level Measures
  • are chosen locally by district alliances based on local needs, demographics and service configurations
  • must demonstrate a direct line of sight between the actions and the improvement milestone
  • are used to measure local progress against quality improvement activities.

Current System Level Measures

The Ministry of Health worked closely with the health sector to co-develop the System Level Measures, which are:

  • Ambulatory Sensitive Hospitalisation (ASH) rates for 0–4 year olds (keeping children out of hospital)
  • acute hospital bed days per capita (using health resources effectively)
  • patient experience of care (person-centred care) – this is made up of adult inpatient and primary care patient experience surveys. Further information and reports can be found on the Health Quality & Safety Commission website.
  • amenable mortality rates (prevention and early detection)
  • babies living in smoke-free homes (a healthy start)
  • youth access to and utilisation of youth appropriate health services (youth are healthy, safe and supported). This SLM is made up of five domains with corresponding outcomes and national health indicators.

All measures are held in an online Measures Library.

How the health sector uses System Level Measures

System Level Measures recognise that good health outcomes require health system partners to work together. Therefore the district alliances are responsible for implementing System Level Measures (SLMs) Improvement Plans in their districts. District alliances are local leadership teams that include the DHB of domicile and at the minimum, all the PHOs providing health services to the population of that district.

District alliances are responsible for:

  • harnessing perspectives from all relevant parts of the health system to identify shared vision and key objectives
  • applying alliancing principles (way of working) – the Alliance Leadership Team Charter outlines the key principles and rules of engagement.
  • using SLMs to drive system integration in their districts
  • allocating resources required for the development, implementation, monitoring and reporting of the SLMs
  • leading the development of the SLM improvement plan.

The DHB is responsible for submitting the SLM improvement plan and quarterly reports on behalf of their alliance as part of the annual planning process.

The Ministry of Health approves the SLM improvement plans.

More information

The following information can be found on the Nationwide Service Framework Library:

  • the Guide to Using the System Level Measures Framework
  • detailed guidance for alliances to develop the Improvement Plans
  • System Level Measures Improvement Plans
  • examples of different alliance approaches to development and implementation of System Level Measures Improvement Plans
  • trend data for the System Level Measures.

In this section

Back to top