While under pressure to deliver quality and efficiency, healthcare institutions lack a unified performance management approach. Variations in KPI sets, incompatible IT systems, and limited integration into daily practice hinder comparability and strategic steering. Overemphasis on financial indicators leaves clinical outcomes, patient experience, and workforce sustainability underrepresented.

We combined a literature review with eleven interviews across public, private, and university hospitals to map current practices and identify gaps. Additionally, insights from leaders like Hirslanden, Schulthess Klinik, and Geneva University Hospitals and the application of the Value Proposition Canvas influenced the design of a practice-oriented framework, structured around strategic, measurement, data, and application layers.

The framework enables systematic performance improvement across seven key dimensions: clinical effectiveness, patient safety, operational efficiency, financial performance, patient-centeredness, workforce sustainability, and governance & learning. It connects strategic objectives to measurable outcomes, embeds standardized KPIs into interoperable IT systems, and supports real-time monitoring through user-friendly dashboards. Benchmarking tools aligned with national indicators (e.g. ANQ, SwissDRG) allow internal and external comparison, fostering transparency and learning between institutions. Key recommendations include piloting with a minimum viable product (MVP), defining data ownership and validation processes, and establishing regular interdisciplinary performance dialogues. The framework provides a clear roadmap to improve comparability, decision-making, and performance outcomes for Swiss hospitals and clinics.