Im­prov­ing Per­for­mance Del­uge amid the of Data (and Change)

Mea­sure­ment is the name of the game in im­prov­ing health­care op­er­a­tions th­ese days, but what to mea­sure, how to mea­sure, and just get­ting started are real chal­lenges for many or­ga­ni­za­tions. Here are five ques­tions—and an­swers—to of­fer clar­ity to this compl

Modern Healthcare - - THE WEEK AHEAD - By Christina Galoozis, Mod­ern Health­care Cus­tom Me­dia

What does “bal­anced per­for­mance” mean and why should hos­pi­tals seek it?

KV: It’s a strate­gic prac­tice used to mon­i­tor suc­cess. No one met­ric can cre­ate a bal­anced story, which is why con­ven­tional per­for­mance man­age­ment sys­tems are in­suf­fi­cient—of­ten mea­sur­ing only financial, op­er­a­tional or qual­ity re­sults. Th­ese mea­sures alone, though es­sen­tial and im­por­tant, fail to tell the com­plete story of the busi­ness re­al­i­ties hos­pi­tals now face.

Op­ti­mal ac­com­plish­ment only hap­pens when all are aligned on the same goals and march­ing for­ward in tan­dem, each rec­og­niz­ing their con­tri­bu­tion to the ‘dot’ mapped on a scorecard.

Why is bal­anced per­for­mance im­por­tant in to­day’s health­care en­vi­ron­ment?

KV: We have to ex­am­ine cause and ef­fect re­la­tion­ships more to­day than ever. The busi­ness of health­care and the pro­vi­sion­ing of health­care now have in­ter­con­nected strate­gic aims. As we move from fee-for-ser­vice to value-based care, see­ing all the com­po­nents of the value equa­tion cre­ates a tip­ping point be­tween the frag­mented prac­tices of to­day to fluid con­tin­u­ums to­mor­row.

How can or­ga­ni­za­tions pri­or­i­tize the right ini­tia­tives that will drive bal­anced per­for­mance im­prove­ment?

KV: Keep ask­ing “why?” and al­ways de­mand that the ini­tia­tive solves mul­ti­ple chal­lenges—that’s the essence of in­tel­li­gent in­for­ma­tion vs. just in­for­ma­tion. For ex­am­ple, want­ing to im­prove length of stay is a big task as there are many com­po­nents—Did they stay longer due to com­pli­ca­tions? Was it a week­end stay? Were there de­lays in the di­ag­nos­tics or the treat­ment modal­i­ties? Were there pa­tient pref­er­ences? It’s a symp­tom of some­thing closer to the tip of the spear. We know that pa­tients ex­pe­ri­enc­ing sep­sis stay longer, have in­creased mor­tal­ity and mor­bid­ity, and cost more. What­ever you are solv­ing for should have a ‘triple rip­ple ef­fect’. Pri­or­i­tize that one.

The met­rics of the 100 Top Hos­pi­tals ® bal­anced scorecard are placed to demon­strate in­ter­de­pen­den­cies, that none are mu­tu­ally ex­clu­sive and can be mon­i­tored to an­a­lyze the move­ment be­tween them. We have con­sul­tants spe­cial­ized in the art of iden­ti­fy­ing this ex­act thing—find­ing the non-ob­vi­ous, which some­times turns out to be the ob­vi­ous. Our Road to 100 Top Hos­pi­tals ® con­sult­ing en­gage­ment helps hos­pi­tals and health sys­tems make im­prove­ments in op­er­a­tional and qual­ity per­for­mance— in­clud­ing clin­i­cal out­comes—so that they can join the ranks of the top hos­pi­tals in the na­tion by op­ti­miz­ing bal­anced per­for­mance.

How of­ten should you “bench­mark”?

KV: The ma­jor­ity of or­ga­ni­za­tions bench­mark monthly sim­ply be­cause at that point you have a co­hort of data that has enough power to show sta­tis­ti­cally sig­nif­i­cant im­prove­ment. Time­lines should al­low suf­fi­cient time for change. Re­mem­ber, we are aim­ing for pal­pa­ble re­sults. Some­thing you can feel.

What are some proven best prac­tices that Tru­ven Health sees when it helps or­ga­ni­za­tions be­gin their per­for­mance im­prove­ment jour­neys?

KV: Be­gin is the op­er­a­tive word. Most or­ga­ni­za­tions don’t get far on their jour­ney not be­cause they aren’t mea­sur­ing the right met­rics, but be­cause the cul­ture isn’t aligned. So to be­gin one must give spe­cial at­ten­tion to the fol­low­ing:

• Trans­parency on KPIs—mea­sur­ing what ac­tu­ally mat­ters

• Align­ment of lead­ers and staff

• Con­sis­tent adop­tion in a sys­tem­atic way across the or­ga­ni­za­tion

• Ef­fi­cient and ef­fec­tive at­tain­ment of re­sults.

KATHY VANENKEVORT

IS A CLIN­I­CAL EPI

DEMIOLOGIST AND

VICE PRES­I­DENT IN

THE TRU­VEN HEALTH

AN­A­LYT­ICS PRAC­TICE

OF CARE SO­LU­TIONS.

SHE HAS 21 YEARS

OF EX­PE­RI­ENCE IN

HEALTH­CARE QUAL­ITY

AND OP­ER­A­TIONS OF

HEALTH­CARE SYS­TEMS.

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