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ESSAY HCA 620 Lecture 6 Measurement
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ESSAY HCA 620 Lecture 6 Measurement
HCA 620 Lecture 6
Measurement
The phrase “What gets measured gets done” has been attributed to the likes of Edwards Deming, Peter Drucker, Tom Peters, and others. The obvious converse − “what doesn’t get measured doesn’t get done” − may also be true. In either case, it is not the actual measuring (Hawthorne effect aside) but the reporting of the measuring that has the greater effect on performance. For your business plan, you will want to spell out how you intend to measure the performance of your program, when you will measure, how you will measure, what tools you will use to report, and the frequency of reporting. Also, any known goals you will have for these should be communicated as well. The reason for having this in the business plan is twofold. First, it tells the reader that you have thought about how your program will perform and the expectations that you have. Generally a plan is better thought out if you have some future stated performance that you are striving for. You should have verbally described this in your vision statement. Now you are giving a more objective description. Second, it tells the reader what they can expect regarding the frequency of reporting and the format.
Descriptive and Predictive Metrics
There are many ways to measure any program, and you will need to decide which metrics make the most sense. This means the ones that will help you get a clear picture of how your program is running. Generally, there are two types of metrics: descriptive and predictive. Descriptive metrics tend to be ones that are fairly general and give a good overview of a program’s performance; whereas, predictive metrics are narrower and give an indication of how a descriptive metric will turn out. For example, a nursing unit may use a metric called the “total cost of labor;” which would be a descriptive metric. If this were reported each month, you would only know your performance after it was too late to make any changes to improve the outcome. To support better performance, you may have a predictive metric such as “nursing hours per patient per day.” In this way, assuming you have valid targets, you could modify your labor cost daily to stay on track so that by the end of the month your total cost of labor would be on track (or at least you would know ahead of time and can prepare for the phone call from the finance department). It is a fine line between what is descriptive and predictive since the monthly labor cost is predictive of yearly labor cost. The point is to include both types of measures.
Another consideration when describing how you will measure is the frequency or how often you will measure. Many factors will need to be assessed when making this decision. Ease of data collection can have a significant impact. If it is difficult to get the data or it has to be done manually, you may not want to do it often. On the other hand, especially with the amount of automation fostered by electronic health records, and financial and quality IT systems, it may be possible to get updates hourly. The best timeframe to pick is one in which enough time has passed for you to see a significant change without being so long that you cannot make modifications soon enough to minimize a negative outcome. Many times, your systems will only update the data at specified timeframes, and that may be what you choose. Monthly financial metrics are a good example of this.
Measurement Tools
There are many tools that you can use to report your performance. In health care, the two most common methods are using charts and a balanced scorecard. The term chart is often interchanged with graph. The two most common charts are column/bar charts and line charts. Column charts have vertical bars, while bar charts have horizontal bars. In either case, they are most useful for comparing data that is for a single point of time or for metrics where you are expressing the data as a percent of the whole. Examples would be the number of clinic visits per clinic for one month, or, for all of the visits in a given month, what percent were men verses women. If you are comparing data over a period of time, a better chart to use is a line chart. Using the clinic visits per month scenario, you would have a data point for each month in a year and the line between them would show you relative value between the months and any trend that may be occurring across the year.
A second tool for reporting business data is a balanced scorecard. As the name implies, a balanced scorecard shows metrics reflective of more than one category and the most common areas are quality, service, employee satisfaction, and financial. By looking at more than one area, you can make your decisions regarding the performance of a program from more than one viewpoint. These viewpoints are often conflicting and therefore provide a more balanced look at your program. The metrics in a balanced scorecard are most often descriptive in nature.
Finally, you will want to describe in your plan how often you will report your performance. Often this is dictated by when the information is available and is parallel to the discussion of when to measure. Obviously, you cannot report until you measure. Another consideration is the nature of your audience and what and when they need to hear. If you are reporting to the board of directors and they meet quarterly, then that will dictate when. It may also dictate which metrics, as generally, they will want higher level metrics (total labor cost, not nursing hours per day). The most common timeframe is monthly and usually within a week or two of when the data is available.
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ESSAY HCA 620 Lecture 6 Measurement
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