Transparency Reporting through Statit piMD—A Look at Our Future

Like the blind man in the story, everyone sees the elephant differently. There are as many definitions of transparency reporting as there are people giving a definition. For the sake of a working definition, I offer the following:

We all know reasons why transparency reporting is important. Some include:

• Helps motivate our own internal performance initiatives
• Provides a vehicle to build needed confidence in the care delivery system
• Maintains and/or increases our competitive stance vis-à-vis other providers in our care delivery area.

OK. We know what it is and we know why it’s important but…what more can we fit on our plate? We are already producing internal operational measures, core measures for the Joint Commission, CMS and other regulatory institutions, as well as board of director or trustee reports. Are you asking for more when our resources are already stretched above capacity? If so, maybe it’s time to forget everything I ever learned and become a software developer!!!! You will be pleased to know that nothing quite that drastic will be necessary. Statit and its Performance Indicator & Management Dashboard (piMD) solution can help!

The issue boils down to divergent needs…on the one hand, you need process improvement analysis which includes control limits, p charts, action plans, rule violations, etc. True continuous performance improvement cannot be successfully deployed without these tools. On the other hand, the consumer accessing the transparency reports on your web site won’t understand these tools…simply put, they want “just the facts, ma'am.”

Let’s say you want to link to your spreadsheet, Access file or database, bring in the data and provide an operational and internal measure…let’s use “Administration of Beta Blockers Prior to Arrival” as our example. Our data contains a numerator (those receiving beta blockers) and a denominator (those eligible) and we want to show a p chart which calculates percentages by period using our data and including control limits, etc. Our internal, operational view might look like the following:

Great! Just what we need to help understand this process and make corrections when/if necessary. But again, does this really make sense to a consumer? In our USA Today world of pie charts, bar charts, etc., we have conditioned the general populace to expect this type of “bubble-gum analysis.” Without creating a separate measure for the consumer, transparency report, Statit piMD allows you to use your operational report and, “on the fly”, change the analysis type without interfering with the operational view. How? Take a look at this.

Above, you see the one screen that “auto-magically” converts an operational measure to one that is used for transparency reporting. The simple drop down boxes provide options. In the example, I brought in the indicators from my Transparency Reports View and in the Group field asked that it limit those to AMI Indicators. I told the system where I wanted the images saved. I can also control Output and Image Type. Finally, I have the ability to change the analysis from the operational measure, in this case from a p chart to a Run Chart. When I hit Display, Statit provides back the following:

See the difference between the Beta Blocker at Arrival p chart and the Beta Blocker at Arrival run chart? If I had requested, the transparency analysis could have been a bar chart or some other, non-SPC chart.

These images are published to the directory I requested. Now, your webmaster can take these images and include them in a document that gets published from your web site.

What gets published to your internet may end up looking something like the following:

CLINICAL DATA:
Heart Attack (Acute Myocardial Infarction) Measures

What is the source for this data?
The clinical measures shown below have been identified by the Joint Commission for Accreditation of Healthcare Organizations as being important indicators of care quality. The Joint Commission is the leading health care accrediting body in the United States. It evaluates how organizations comply with a broad range of standards, and it accredits nearly 16,000 health care organizations in the United States, including Simas Memorial Health Care. Simas Memorial is fully accredited by the Joint Commission.

The national average includes information from hospitals that are accredited by the Joint Commission.

Heart Attack Mortality

• A lower number is better

What this means: This measures the percentage of heart attack patients who die during their hospital stay.

The Expected Mortality shown in this comparison is a calculated measure developed by the Joint Commission on Accreditation of Healthcare Organizations, and it is based on “risk adjustment” information about Simas Memorial patients. It reflects the fact that some patients are sicker than others or have preexisting conditions that make death more likely. This measure shows Simas Memorial actual and predicted outcomes as well as our performance in relationship to other academic health centers.

Why it’s important: A low mortality rate is an indicator of a good patient care process. This measure shows how Simas Memorial compares with hospitals nationwide.

Aspirin Given at Arrival

• A higher number is better

What this means: This measures the percentage of heart attack patients who receive aspirin within 24 hours of arrival at the hospital.

Why it’s important: Aspirin is beneficial because it improves survival rates by reducing the tendency of blood to clot in heart vessels.

Beta Blocker Prescribed at Arrival

• A higher number is better

What this means: This measures the percentage of heart attack patients who were given a medicine called a beta blocker when leaving the hospital.

Why it’s important: This treatment has been shown to reduce further heart damage in heart attack patients.

What we’ve learned…

• Transparency Reporting is the right thing to do for many reasons.
• Creating these reports is painless, simple and efficient.
• One doesn’t have to quit their day job and become a programmer!!

Transparency is really a key to insuring that the culture of improvement is sustained, both internally and externally, so that the public understands that the people delivering healthcare are trying very hard to deliver the very best care while also protecting them. By creating transparent reports, the public gains confidence that the provider is willing to place “all the cards on the table” by reporting the good, and sometimes not so good, of healthcare delivery.

Statit Software has many ideas on how you can get started in this area. Feel free to call us at (541) 752-4500 or send an email to for a discussion and demonstration of this functionality.