Richard Corcoran
April 19th, 2006, 09:51 AM
This section will house information, materials, and useful tools related to the practical use of dashboards and scorecards to improve patient safety. Please feel free to contribute.
Overview
Hospitals are getting more difficult to manage every day. Management has to do more with less – more regulations, more complexity in care, more technology, changing reimbursement, yet fewer staff. Goals are also more challenging. The 2001 Institute of Medicine (IOM) report, Crossing the Quality Chasm (http://www.iom.edu/?id=12736), set the quality bar high. Care must be safe, timely, effective, efficient, equitable, and patient-centered. JCAHO’s National Patient Safety Goals (http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/06_npsg_cah.htm) provide evidence-based, consensus safety standards. IHI’s 100K Lives Campaign (http://www.ihi.org/IHI/Programs/Campaign/) is all about keeping patients safe. Everybody agrees that hospital care must be made safer. The question remains – how do we go about making care safer in our hospital?
Root cause analysis of “near misses”, mistakes, errors, and adverse events clearly identify that “cultural” causes loom the largest, including:
Poor communication among care providers;
Separated / segregated polices, programs and disconnected reporting systems within;
Gaps and overlaps of hospital committees and task groups, many under the impression that action is being taken by other groups;
Insufficient means to identify and measure patient safety improvement initiatives in order to analyze contributory issues and identify improvement strategies.The evidence is clear and compelling –if you are going to make hospital care fundamentally safer for patients and their families, you have to develop a “culture of safety”. This is no simple task. Hospitals are complex organizations with strong established traditions based on professional autonomies and hierarchies. To transform culture in this environment, you must have a crosscutting way to understand, discuss, and manage complex organizational change. Communication, teamwork, and leadership skills are key.
Improving patient safety requires a major commitment by everybody in the hospital to take a long and hard look at how they might change practices to get better and safer results. The search for these “best practices” is ongoing.
Measurement
No organizational practice should truly be considered a "best practice" unless it meets the test of measurement. If the practice works as advertised, you should be able to see, define, and measure the results. Here are three quotes to consider –
”If you can’t measure it, you can’t manage it.”
Peter Drucker
“What gets measured, gets done”
Peter Drucker
“All good-to-great companies began the process of finding a path to greatness by confronting the brutal facts of their current reality. When you start with an honest and diligent effort to determine the truth of situation, the right decisions often become self-evident”
Jim Collins, author of Good to Great
Here’s one way to think about this: If the single most effective way to drive safety improvement strategies is to gain consensus among the key players at all levels about what needs to be done; and, if the single most effective way to gain this kind of consensus is to get everybody on the same page; then dashboards and scorecards are a very effective tools. Many hospitals nationwide are either now using or are considering using dashboards as part of their overall performance improvement efforts.
Dashboards at-a-glance
A dashboard is a way to visually present critical data measures in summary form so that you can make quick and effective decisions. At the heart of any dashboard is the quest to improve organizational performance —whether this is at a strategic level, operational level, or both. Dashboards foster alignment, visibility, and collaboration across the organization. Dashboards enable performance improvement by allowing organizational groups to work together toward the same, measurable ends. This is necessary.
To develop a dashboard reporting system in hospitals, four critical factors should be taken into account:
Factors most important to the organization's success
Critical drivers that influence performance attainment
Relevant measures
Relevant benchmarking dataDashboards allow you to align strategy across organizational boundaries, monitor performance to meet strategic objectives, analyze and take action, make the right decisions, and assign goals and objectives to individuals or groups.
Dashboards allow us to connect the dots. In the world of hospital performance improvement, dashboards (and scorecards) are not just helpful, they are also critical.
One example
If you’re not yet using a dashboard, here’s a model dashboard report (http://www.wsha.org/files/82/Dashboard2006.xls) from the Washington State Hospital Association using an excel spreadsheet that’s easy to understand and adapt.
Stay tuned to this section for additional posts and feel free to contribute to an ongoing exploration.
Overview
Hospitals are getting more difficult to manage every day. Management has to do more with less – more regulations, more complexity in care, more technology, changing reimbursement, yet fewer staff. Goals are also more challenging. The 2001 Institute of Medicine (IOM) report, Crossing the Quality Chasm (http://www.iom.edu/?id=12736), set the quality bar high. Care must be safe, timely, effective, efficient, equitable, and patient-centered. JCAHO’s National Patient Safety Goals (http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/06_npsg_cah.htm) provide evidence-based, consensus safety standards. IHI’s 100K Lives Campaign (http://www.ihi.org/IHI/Programs/Campaign/) is all about keeping patients safe. Everybody agrees that hospital care must be made safer. The question remains – how do we go about making care safer in our hospital?
Root cause analysis of “near misses”, mistakes, errors, and adverse events clearly identify that “cultural” causes loom the largest, including:
Poor communication among care providers;
Separated / segregated polices, programs and disconnected reporting systems within;
Gaps and overlaps of hospital committees and task groups, many under the impression that action is being taken by other groups;
Insufficient means to identify and measure patient safety improvement initiatives in order to analyze contributory issues and identify improvement strategies.The evidence is clear and compelling –if you are going to make hospital care fundamentally safer for patients and their families, you have to develop a “culture of safety”. This is no simple task. Hospitals are complex organizations with strong established traditions based on professional autonomies and hierarchies. To transform culture in this environment, you must have a crosscutting way to understand, discuss, and manage complex organizational change. Communication, teamwork, and leadership skills are key.
Improving patient safety requires a major commitment by everybody in the hospital to take a long and hard look at how they might change practices to get better and safer results. The search for these “best practices” is ongoing.
Measurement
No organizational practice should truly be considered a "best practice" unless it meets the test of measurement. If the practice works as advertised, you should be able to see, define, and measure the results. Here are three quotes to consider –
”If you can’t measure it, you can’t manage it.”
Peter Drucker
“What gets measured, gets done”
Peter Drucker
“All good-to-great companies began the process of finding a path to greatness by confronting the brutal facts of their current reality. When you start with an honest and diligent effort to determine the truth of situation, the right decisions often become self-evident”
Jim Collins, author of Good to Great
Here’s one way to think about this: If the single most effective way to drive safety improvement strategies is to gain consensus among the key players at all levels about what needs to be done; and, if the single most effective way to gain this kind of consensus is to get everybody on the same page; then dashboards and scorecards are a very effective tools. Many hospitals nationwide are either now using or are considering using dashboards as part of their overall performance improvement efforts.
Dashboards at-a-glance
A dashboard is a way to visually present critical data measures in summary form so that you can make quick and effective decisions. At the heart of any dashboard is the quest to improve organizational performance —whether this is at a strategic level, operational level, or both. Dashboards foster alignment, visibility, and collaboration across the organization. Dashboards enable performance improvement by allowing organizational groups to work together toward the same, measurable ends. This is necessary.
To develop a dashboard reporting system in hospitals, four critical factors should be taken into account:
Factors most important to the organization's success
Critical drivers that influence performance attainment
Relevant measures
Relevant benchmarking dataDashboards allow you to align strategy across organizational boundaries, monitor performance to meet strategic objectives, analyze and take action, make the right decisions, and assign goals and objectives to individuals or groups.
Dashboards allow us to connect the dots. In the world of hospital performance improvement, dashboards (and scorecards) are not just helpful, they are also critical.
One example
If you’re not yet using a dashboard, here’s a model dashboard report (http://www.wsha.org/files/82/Dashboard2006.xls) from the Washington State Hospital Association using an excel spreadsheet that’s easy to understand and adapt.
Stay tuned to this section for additional posts and feel free to contribute to an ongoing exploration.