Healthcare

Healthcare Performance Improvement Mistake 9: Measure Twice, Cut Once

Healthcare Performance Improvement Mistake 9: Measure Twice, Cut Once 150 150 Novaces | Lean Six Sigma Training | Process Improvement | Healthcare | Government | Defense
Submitted By: Brian MacClaren

Do you believe your organization has too many performance measures or too few? Having good data available enables better decisions to be made, but not when the expense of collecting all the data is so high that it severely limits your resources to fix problems and improve quality. This results in a lot of measuring, but rarely a chance to make the cut.

If asked if you believe your organization has too many different measures or too few, how would you answer?

a) We have way too many metrics, but they all provide valuable information
b) We have too many metrics and they don’t provide the information we need
c) We have just the right amount of metrics to balance the need for information and action
d) We have too few metrics to adequately measure performance

If you answered “c,” then you are among those who have implemented a performance management system that truly works for the entire organization. Sometimes we only have the resources to track required measures like CMS Core Measures. Or, we might track so many different measures that at time we believe we are some kind of data manufacturing company instead of a hospital. In this case, it feels like more time is spent compiling data and reports than actually working on improvement projects.

So, what are the characteristics of a good performance measurement system?

The system must be designed as a tool for tracking financial results while simultaneously monitoring the system’s capabilities to meet customer needs, key performance indicators, and critical success factors.

At the executive level, the system represents the acme of a hierarchy of indicators that, ultimately, reach both the bedside and the loading dock. Ideally, each employee knows how his or her work impacts the uppermost corporate indicators. Given these considerations, many organizations seek to implement the balanced scorecard.

Example of a balanced scorecard.

Although the balanced scorecard represents a vision and a benchmark for measuring performance in an organization, the first step is beginning to design effective performance measures. Here are some things to think about when doing just that:

  • Indicators are specific. A hierarchy of metrics links layers of accountability so that staff at every level of the organization are measured on their contribution to metrics at the highest level. There is a clear line of sight upward, from each worker’s job to the executive dashboard and from the dashboard down to division and departmental indicators and the specific activities moving the dial.
  • Indicators are logical and based on clear operational definitions. process capability and performance against objectives is quantifiable.
  • Indicators are actionable. performance improvements can be linked directly to changes in performance indicators
  • Indicators are relevant. Everything that matters (the critical few indicators defined by organizational strategy) is measured and nothing more.
  • Indicators are related to time. Performance over time (trending) is evident and key processes are measured frequently enough to allow for timely corrective action.

As we work towards moving our organizations to “answer c,” the effort will certainly require a collaborative effort involving all stakeholders to find the most efficient use of the organization’s valuable resources. It will be an effort to separate the “critical few” from the “trivial many.”

Sustainment- The Path to Self-Sufficiency

Sustainment- The Path to Self-Sufficiency 150 150 Novaces | Lean Six Sigma Training | Process Improvement | Healthcare | Government | Defense
Submitted By: Dr. Bahadir Inozu

Below is an excerpt from Chapter 7 of our recently published book, Performance Improvement for Healthcare: Leading Change with Lean, Six Sigma, and Constraints Management

In today’s competitive and highly volatile economic environment, change is the rule while the steady-state is momentary and uncertain. Change management must be embedded in the technical transformation that is taking place—a process within a process. Successful continuous performance improvement deployments must address change management throughout the deployment process. The devil is in the dynamic details. How to implement a change program successfully is critical when dealing with another confounding variable: the erratic changes of human behavior reacting to changes. The most successful organizations have people who must learn to continuously adapt to change.

Change happens, unabashedly. Whether it is planned or unplanned, positive or negative, change is the new norm. In healthcare, change has transmuted to an oxymoron, a constant: technological changes, regulatory changes, legislative changes, economic changes, demographic changes. Sometimes these changes are not incremental, but are revolutionary, affecting every part of the system. Change is either imposed or it is proactive. When W. Edwards Deming cynically said that “change is not necessary, survival is optional,” it was never more true than it is of healthcare today. When asked to describe the pace of change in healthcare today, a nurse wearily replied, “Change is all there is.”

Proactive change, such as a Performance Improvement for healthcare deployment, is intended to move the organization in a positive direction. Performance Improvement, by design and by definition, is a change initiative. While all change does not lead to improvement, performance improvement inevitably requires change. With the barrage of change that is already pummeling healthcare, performance-improvement initiatives may be perceived by overworked and overwhelmed staff as the next last straw. Thus, change management skills and methods are fundamental to any performance-improvement endeavor. Performance-Improvement practitioners are expected to act as change agents and change leaders. They need to be equipped, empowered, and trained to facilitate and manage change. Any successful performance-improvement deployment will be founded on change management principles and methods.

Click here for a free download of Chapter 1 of our book, Performance Improvement for Healthcare: Leading Change with Lean, Six Sigma, and Constraints Management.

Novaces | Lean Six Sigma Training | Process Improvement | Healthcare | Government | Defense