The healthcare industry is going through some
exciting times in regards to Quality Improvement
and the use of Statistical Process Control.
It is the best of times and the worst of times.
It is the best of times because SPC provides
the information to help healthcare workers understand
their processes and find areas for healthcare
improvement. It is so exciting to monitor the
changes your process improvement efforts have
produced.
It is the worst of times because, “Oh
my, look at all the work we have to do. Gather
all this data, build the charts and reports,
distribute them, update and redistribute them,
submit the information to the accreditation
bodies and resubmit."
I’m sure you are aware that Statit products,
particularly Statit
piMD, help tremendously to get you through
the “worst of times” by eliminating
so much of the manual work involved. Statit
has been helping customers with this for decades.
But what about the “best of times”?
SPC tools are a critical part of the accreditation
process of JCAHO and CMS. ORYX provides methods
for charting and interpreting your data using
these tools. These tools are typically used
on a quarterly basis against the Core Measures.
From an accreditation standpoint, these do well.
And Statit piMD presents this information to
your organization in an easy- to-maintain, easy-to-access
manner.
However, from an operational standpoint, you
may want to know much sooner that a process
has shifted. For example, you may want to know
that the HF1 – Discharge Instruction percentage
has decreased well before the quarterly report,
in order to find the assignable cause and remedy
it. You would certainly like to know you have
an issue well before the end of the quarter.
Depending on the number of patients you work
with for a particular measure, you may well
wish to look at your charts using a smaller
period.
But the great thing about SPC tools is that
their usefulness is not limited to Core Measures.
There are so many processes in a healthcare
organization (or any organization for that matter)
that can benefit from the process improvement
capabilities of SPC. A few years ago, one of
our customers used Statit SPC tools to validate
a protocol change in the ER in improving the
time to neurologist for stroke victims.
SPC charts can indicate that something has
changed in a well-running process, or that a
deliberate change in a process has had the desired
effect.
Other measures as well become important to
a Quality Organization. Indicators on such things
as Length of Stay, Falls, Medication Errors,
Admissions and Discharges are certainly important
and you could learn something from SPC charts
of these measures.
Statit piMD Scorecard Example
Statit piMD SPC Chart Example
Examples of financial indicators are such items
as Operating Margin, FTE Cost, Bad Debt Expense
or Medicare Payment Reductions. Patient satisfaction,
restock from store, pharmacy transactions, radiology
or lab turnaround, medication errors and outreach
success are other examples.
This is the best of times because of the excitement
of using these tools to improve our organizations
in so many ways. But I don’t mean to suggest
that we measure and chart everything in sight.
Remember, this is the worst of times as well.
The Balanced Scorecard concept is often a good
way to view this situation. It basically tells
us to find a few critical indicators in four
perspectives of our organization:
| 1. |
Financial Perspective |
| 2. |
Customer Perspective |
| 3. |
Internal-Business-Process
Perspective |
| 4. |
Learning and Growth Perspective |
These critical indicators should be such that
they will indicate the health of the organization
as well as support our mission, goals and strategies.
Choosing these indicators is no easy task, but
it is worth it.
Often, new measures and indicators will arise
in response to a particular issue. They will
be used until the problem has been solved and
the process monitored long enough to ensure
that the issue has been put to bed. It may arise
again later (as our friend monitoring Time to
Neurologist has discovered) and we can revive
the SPC charts to revisit the issue.
Statit can help you through the “worst
of times” so that you can more fully enjoy
the “best of times”. For many healthcare
organizations, Statit piMD has proven enormously
beneficial in providing accurate, organization-wide
information in a timely and time-saving manner.
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