Making decisions without reliable data is a costly and indefensible mistake in today’s healthcare environment. Clinical skills and professional tenure alone will not improve the performance of hospital systems to meet the changing expectations of value-based purchasing. The hospital’s performance is dependent upon much more than the average FIM™ change or CMI average and yet managers fail to influence performance or quality by missing the opportunity to pull the operational levers.
However, with available technology and few simple management practices, virtually any clinical operation can improve decision making and deliver optimal outcome performance. Any business unit requires the following in order to make informed decisions:
-Accurate and timely data;
-A mechanism for data analysis;
-A plan to utilize the information in daily operations;
-Ongoing evaluation of the entire data process.
A common complaint among clinical managers is that they lack the information they need to do their jobs. Usually the opposite is true. Individual business units usually have more than enough information. The problem is not knowing what to do with the data.
In all healthcare organizations, a manager needs to keep four separate and distinct functions running effectively and in balance: finance and accounting, human resources, clinical services and the patient care experience. Effective management requires the following data:
- Volume trends
- Labor cost per unit of service
(Total labor cost compared to total volume; payment trends)
- Supply cost per unit of service
- hospital’s performance
- Trending budget reports
- Productivity reports with benchmark comparisons
- Payer mix
- Case mix
- Patient margin by service line
- Daily staffing patterns
- Patient satisfaction indicators
- Key clinical performance metrics
If this data is readily available, thoroughly understood and well managed, it can be assumed that well-informed clinical, operational and business decisions across all clinical departments will result.
Unfortunately, too many hospitals do not adequately value the collection, management and analysis of data. Clinical managers perceive the process as complicated and of little value. The culture of the organization may not have evolved from an orientation of compliance to a quality and performance orientation. Value-based purchasing will require organizational changes to assure sustainable transformations and that data and its use are properly valued. Change will require:
-Senior management must be supported by appropriate personnel with the analytical performance and financial skills in tracking, supporting, and monitoring results;
-These personnel must be integrated into the clinical structure to consult with each department, provide data/trends analysis and educate department leaders on how to perform their own analyses, as accountability should not shift away from managers;
-Frequent review of departmental performance for both favorable and unfavorable variance trends to celebrate success and create action plans to get departments on track where necessary;
-All clinicians will need to take ownership of the quality and performance status to affect hospital improvement. Transparent accountability must be pervasive throughout the hospital organization.
The Affordable Care Act will demand a more accurate and timely intelligence to influence planning and clinical operations to maximize the value of patient care.