The ability to quickly address rapid changes in the healthcare environment is a distinguishing characteristic of top-performing hospitals. At
St. Joseph’s Hospital Health Center in central New York, record growth in several key service lines necessitated a new way of looking at analytics.
While substantial data was stored within our health IT system, it was out of reach to those who needed it most: administrators, physicians and clinicians. Decision support was revenue-focused, cost-centered, and centered almost exclusively on financial results. A complete structural overhaul was in order. Having integrated financial and clinical intelligence at the point of need would support more effective decision making and help drive better patient outcomes across the enterprise.
The Transformation Begins
St. Joseph’s began the process by creating a consolidated business analysis unit (BAU). The revised organizational structure promotes more effective data utilization and holds numerous advantages over our old, fragmented system. For example:
- Executives and staff now have a single, organization-wide source for analytics
- Analysts report directly to a common department, which reports directly to the chief operating officer
- A dedicated analyst is assigned to each department director
- Data intersects all areas of the patient experience (clinical, financial, quality) to produce a comprehensive, business-driven overview
We transformed from a department that simply produced reports into one that facilitates decision-making and enables support for large-scale strategic initiatives.
Communicating Meaningful Information
With the BAU up and running, we implemented McKesson’s
enterprise intelligence solution to support our data-driven improvement efforts. The technology assists us in providing executive leaders and managers with meaningful information to monitor performance on key operational and quality metrics.
The detailed scorecards make it easy to drill down to the department and individual level to identify the root cause of any performance problems. We also empower staff to be independent users of the data. They can create and model their own reports, applying the intelligence to improve their business and clinical processes. As a result, we no longer need complex tools or a large analytical department to make daily decisions.
Our chief operating officer, after preparations with a BAU member, presents enterprise scorecards to the board of directors each quarter to review performance in key areas. Now we not only can tell them what happened, but why. Directors receive the reports on a monthly basis. Using shared scorecards, St. Joseph’s aligns the entire enterprise to common goals.
The monthly operational dashboard:
- Provides standard financial and quality reporting for executives and the Board of Directors
- Includes 27 key performance metrics configured from 14 unique data sources
- Cascades and reports metrics performance at the department level
The monthly quality scorecard:
- Provides data that enables managers and caregivers to look at all areas of the patient experience – from admission to discharge
- Offers a single, unified place to track all publicly reported quality measures
- Features 20+ key performance metrics – including core measures, readmission rates, and patient safety and satisfaction figures configured from six unique data sources
- Cascades and reports metrics performance at the nursing unit and individual level
We found that the time we took to do the initial build of the scorecards was about equal to the effort to create monthly spreadsheets. Now the data updates automatically, and all we have to do is audit and analyze the data.
Transparency and Accountability
Our analytic scorecards are delivered via an interactive, visual framework that helps provide greater transparency and accountability, along with measurable outcomes at varying levels. Key performance indicators are reported and trended over time. Leaders quickly can see which areas are performing well or lagging compared to expectations and work directly with departments or physicians identified as outliers.
For example, if the data shows that Unit #3 has the most falls in the organization, managers can review results with staff, draft an action plan and work to implement best practices in fall prevention. A physician leader can use the data to meet with physicians to reinforce service line procedures and protocols, such as use of generics when appropriate.
Alternatively, reviewed analytics assist with coding accuracy. For example, one physician noticed that there was a reportable patient safety event listed on his scorecard that didn’t make sense. The BAU was able to work with Medical Records and found that the present on admission code had been missed for the event, and we were able to correct the error. This feedback cycle prevented a reported safety event that could have resulted in a negative impact on pay-for-performance metrics.
Dramatic Clinical Improvements
By broadening our use of analytic data from simple financial decision support to comprehensive clinical and financial analytics for clinicians, physicians and administrators, St. Joseph’s has achieved substantial improvements in a short period of time.
As recently as 2009, our hospital had one of the highest infection rates in the state of New York. We struggled with effective ways to address this issue. Using analytics to create actionable data, hand-washing compliance increased dramatically. We also significantly reduced the rates for clostridium difficile (C. diff) infection and central line-associated bloodstream infection (CLABSI) in less than a year. The estimated total costs avoided from these infection prevention initiatives exceeded $1 million.
Enterprise intelligence is the driving force that enables us to quantify outcomes, review them internally, make decisions about patient care and operations quickly and easily, and guide organizational strategy. Having data at the point of need helps us improve our daily operations and plan for the future with confidence.
St. Joseph’s Hospital and Health Center has been named one of the nation’s “Most Wired” organizations for 2013 by the American Hospital Association’s Hospitals & Health Networks® magazine.
St. Joseph’s Hospital Health Center Infection Prevention Results
Using an enterprise intelligence solution, St. Joseph’s Hospital Health Center implemented infection prevention initiatives that avoided more than an estimated $1 million in costs, as well as yielded substantial clinical improvements:
- Increased hand-washing compliance from 74% to 95% in 15 months
- Reduced C. diff infection rates from 1.6 to .5 cases per 1,000 patient days in six months
- Cut CLABSI rates from 1.0 to .4 in six months