Feature: Service line dashboards help identify missed targets
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In one simple glance at the daily, weekly or monthly scorecard, Stewart-Huey knows what targets she has hit and which ones she has missed. Missed targets are assigned a red dot, achieved targets get a green dot.
"We also used to have yellow dots as a warning, but people tended to not take them as seriously as the red, so we don't use yellow anymore," Stewart-Huey said in an interview. "Either you're performing or you're not. And there is nothing in between."
Stewart-Huey recently lectured about her dashboard's effectiveness at the 15th Annual Update on Pediatric and Congenital Cardiovascular Disease in Scottsdale, Ariz.
The dashboard software called QlikView (Qlik Technologies) was first used by the cardiology group at the Children's Healthcare of Atlanta Silbey Heart Center. Because of the dashboard's success in cardiology, the hospital quickly adopted it. A license for the software is purchased and a consultant helps to develop reports.
Children's has committed the resources of six to eight people dedicated to using and applying QlikView, while cardiology has hired its own team to manage the dashboard.
"I can click on my computer and bring up many different types of reports, such as referring physician satisfaction, charges by DRG, infection rates, employee retention, financials and resource utilization, which as an administrator, is very useful," Stewart-Huey said. "We also have developed reports for clinicians and nurses so they can extract data for use in research."
The main reason, however, for having a dashboard is to assess where the actual data falls in reference to projected or anticipated usage.
For example, a decline in patient volume had the hospital struggling with salary costs, which showed up on the executive scorecard. "We were not meeting our projected targets. We were in the red," Stewart-Huey said.
Cardiology staff would say they are doing the best they can, but the dashboard is concrete evidence that the projected salary targets were not being met. 'We may want to explore ways of doing it better,' Stewart-Huey would say to the staff.
The cath labs, in particular, were having a difficult time adjusting staffing levels to meet the fluctuation in volume. Stewart-Huey asked them to put all ideas on the table and review all processes. How did they schedule patients? How did they schedule their team? Who did they have on-call?
"We have three cath labs and if we bring in two teams and one team is fully productive while the other sits idle at times, that is not a good use of our resources," she said.
Some of the suggestions that came out of the meetings to address the scheduling issues were to have some staff spend time on research; have others be on backup call; and to deviate from traditional scheduling and perhaps stagger a shift to better accommodate volume and acuity.
Consequently, salary expense management has improved by 10 percent and productivity enhancement by 5 percent from 2009 to 2010.
"The bottom line is that if you're not measuring specific targets such as employee and physician satisfaction, rates of readmissions, rates of infection, supply utilization and resource use, you won't know when they are off target and if they need to be improved. You need to have a baseline measurement that you can compare with future marks."
Regarding physician satisfaction, surveys had indicated that referrers were satisfied with the quality of care from the hospital, but they were not satisfied the communication with clinicians. "We had huge initiatives around that, and then we measured it, tracked it and monitored it so we could improve," Stewart-Huey said.
She concluded that scorecards that are populated via intelligent data extraction provide the means for faster, better business and clinical decisions, including:
- Enhancing the ease and timeliness of reporting dashboard metrics;
- Enabling the service line and physician practice to obtain years of clinical and financial data for more adept business decision making, and driving initiatives in eliminating unnecessary practice variabilty, developing best practices and determining appropriate utilization of services; and
- Providing a favorable return on investment by instantly retrieving data for analytics and improved clinical decision support.