KPI Presentation 2012 . Pptx

8/13/2019 KPI Presentation 2012 . Pptx

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"If you can't measure it you can't manageit

1


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KeyPerformance

Indicators

"If you can't measure it you can't manage it2


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Objectives

Improve the understanding of KPIs and whatthey indicate.

Identify the Key Performance Indicators at

SKMC

PDCA, RCA



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Quality measurement reflectsthe compassion,

safety and effectiveness ofnursing care.

It is both a challenge and an

opportunity.


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It begins with the

Mission

6"If you can't measure it you can't manage it


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"If you can't measure it you can't manage it

MISSIONTo provide compassionate, patient centeredcare of the highest qualityin a setting ofeducation and research

VISIONSheikh Khalifa Medical City will be recognizedas a preeminent medical center that strivesto provide an outstanding patient experience,superior clinical outcomes and improved qualityof life for the people it serves.

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VALUES

Collaboration

Compassion

Integrity

Patient Safety and Quality

"If you can't measure it you can't manage it 8


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In 1859, Florence Nightingale created the

worlds first performance tables of

hospitals. Florence Nightingale was the

architect of the modern British (arguablyEuropean) hospitaland, most importantly,

the means of measuring its performance.

It may seem a strange principle to

enunciate as the very first requirement in ahospital that it should do the sick no harm,

An Early Challenge



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History of Evaluating Nursing Care

Quality

Pat ient ou tcom es versus

environmental cond i t ions.

Night ingale also

demonstrated that high

death rates, wh ich were

invariable then in largehosp itals, were

preventable.



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Definitions of Quality(as it Relates to Health Care)



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Definition of Quality

in the 1990s:Meeting customers expectations

Doing the right thing and doing it well

(JCAHO, 1994)

Clinically effective, efficient, and affordable

health services that are delivered

satisfactorily.



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What is an Indicator?

Valid and reliable quantitativeprocess or outcome measure relatedto one or more dimensions of

performance, such aseffectiveness or appropriateness

(The Joint Commission)

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Measures? Metrics?KPI?

Indicators?Performance?


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Performance Management

Management = getting work donethrough others

Managers performance is only asgood as his/her employees

performance

Managersjob = performancemanagement of others


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Performance Improvement

Two Special Objectives in view with regards to disease,namely,

To do good or to do no harm.

VALUE = Qualityof Care+ OutcomeCost


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Measures Focus on:

Consistent indicators across theorganization

Comparison of indicators over time inthe organization

Comparisons with pre-determinedstandard (internal)


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Performance measures are focused on process andoutcomes

Reflect actual practice/ performance

Leaders determine the focus

Set priorities/ goals Collection of data

How to use the data

Detail & frequency of data collection

When do you have enough data to proceed to nextprocess

Analysis ( to compare data)

Act on it!


Quality Improvement Process


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K


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Key These are the impo rtant th ings

that the team does to support the

patient /focus on m iss ion (di rect ly o r

indirect ly)

Performance High , average, low

what do we want as the standard for

ou r pat ients?

Indicators What can we focus on

regu lar ly th at tells us we are (o r are

no t) ach ieving those key goals?



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Specific:Directly supports understanding how the company is performing

relative to one or more of its goals.

Measurable: Is it getting better or worse.

Achievable: Within the reach of the organization.

Relevant:

Can determine the health of the organization by focusing on a few

key indicators.

Time-Based: Performance over time.

Key performance indicators share five

important SMART " characteristics.

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Key (Critical) Success Factors

KPIs measure the health of the

organization

BUT about.

CRITICAL SUCCESS FACTORS?



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Examples of Key (Critical)

Success Factors in Health Care


Leadership

Resources

Relationships

Patient and Family Engagement Competent Management and Finances

Improvement Technique

Expert and Facilitated Assistance Health IT.

Capacity to Deliver Coordination Professional and Staff Roles and Training

(TEAMWORK)

KPI t k f i t


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KPIs are directly linked to the overall

goals of the organization.

Business Objectives are defined atcorporate level.

These goals determine critical

activities (Key Success Factors) thatmust be done well for a particular

operation to succeed.

.

KPIs track performance against

established key success factors



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Key Success Factors (KSFs) only

change if there is a fundamental shift

in business objectives.

Key Performance Indicators (KPIs)

change as objectives are met, or

management focus shifts.

.

Safety"If you can't measure it you can't manage it 26


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How do I interpret a KPI?

Excellence

KPIs do NOT give answers,

rather they raise questionsand direct attention.



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How do I interpret a KPI?

If Our KPI for Infections is this indicates that the business objective,

is NOTbeing fulfilled. This should direct attention to the key success factor.

Problems / Issues should be identified and resolved with a view to

decreasing safety KPIs and therefore achieving the business

objective.

If Our KPI for Infections is this indicates that the business objective,

isbeing fulfilled. This indicates safety practices / education are proving successful.


OK


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OK

Now What?


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measurement without change is waste, whilechange without measurement is foolhardy.

AVOIDmeasurement for measurements sake


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THE PDCA IMPROVEMENT

PROCESS


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Model for continuous improvement.New improvement project.Developing a new or improved design of a

process, product or service.Defining a repetitive work process.Planning data collection and analysis inorder to verify and prioritize problems or root

causes.Iplementing any change.

When to UsePlan-Do-Check-Act


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PLAN

Most time consuming part of PDCA!

1. Develop aim statementWhat are we going to do?

How will we measure it?Why?

2. Identify your stakeholders

- ICD, Physicians, Nurses, QD

3. Take into account timelines, resources, and process


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Aim Statement

1. What are we trying to accomplish?To decrease the number of CLABSI by 50% in 90days

2. How will we know that a change is animprovement?There is an increase in the quality and safety of

the patients and LOS


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3. What changes can we make that will result in animprovement?

(Use data to decide on interventionTechnique used in Emergency dept identified most problematicIdentify causes of not-metCause-and-Effect (Fishbone) diagram todetermine root cause of why ED have

problems meeting standards of CL insertiontechniques )

3. What changes can we make that will result in animprovement?1. Time out check list2. Education/ awareness

PLAN, cont


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Select the project

Understand and clarifythe process

Data

Flowcharting

Brainstorming

Fishbone Diagram

Develop a Plan ofAction

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Effect(Y)

Management Man Method

Measurement Machine Material

Cause

Cause

Cause

Cause

Cause

Cause

Cause

Cause CauseCause

Cause

Ishikawa Fishbone Diagram; Continuous

Process Improvement; Cause and Effect
http://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsxhttp://localhost/var/www/apps/conversion/tmp/scratch_8/FOCUS_PDCA_PI.xlsx


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Provide training, education to physicians

who need to improve

Pilot use of time out check list

Implement in next cycle

Do



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1. Bar chart to compare before and after

2. Was there an improvement? ( Measure it- KPI)

CHECK



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replicating


1. Institutionalize the change (replicating success)2. Continue to monitor

3. If there was no change, do more data

analysis to determine why

4. Root cause

5. The 5 whys

6. CELEBRATE,

REWARD & RECOGNITION!

ACT


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Its not always

easy BUT YOU CAN!


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Where to find the KPIs in SKMC?

Excellence

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"If you can't measure it you can't manageit 50


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What is Benchmarking?

. (There is no single benchmarking process that has beenuniversally adopted)

Measures an organization's internal processes

Helps you understand where you are in relation to aparticular standard

Who performs well and has process practices that areadaptable to your own unit or/and organization

Best Practices Benchmarking is the processof seeking out and studying the best internal

practices that produce superior performance.53

What are


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When an object is divided into a number of equal parts then each part is called a fraction.

We have a box of gingerbread men. There are 5 men in the box.

Each man is of the box contents.

The whole box has 5 fifth parts.

We write it: 1 =

Two gingerbread men are pink.Two pink men are of the box contents.

What are

Numerators and Denominators

2 numerator says how many parts in the fraction

= "divide by"

5 denominator says how many equal parts in the whole

object

Always remember: denominatorcan NEVERbe 0.

Why? Because you cannot divide by 0.


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EXAMPLE:

EXAMPLE:

Numerator =

Total number of ? Not meeting the goal/ benchmark/

standards

Denominator =

Total number of files/patients audited/ checked/ monitored=

sample


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Dashboards


http://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Da

shboard.xls

http://ishare/QMD/default.aspx
http://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xlshttp://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xlshttp://ishare/Pages/category.aspxhttp://ishare/Pages/category.aspxhttp://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xlshttp://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xls


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replicating

Quality indicator dashboards fororganizations are valuablebenchmarking tools, but theinteresting data analysis happens

when you drill down to the unitlevel. You might discover that oneunit has had fewer catheter-

associated urinary tract infectionsthan another unit with a similarpatient population. Then it becomesa question of replicating success


Dashboards


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Dashboards


http://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Da

shboard.xls

http://ishare/QMD/default.aspx

Linking Strategy to Metrics

Help you visualize and track trends on every

level of your business and to align activities withkey goals.

REMEMBER!
http://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xlshttp://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xlshttp://ishare/Pages/category.aspxhttp://ishare/Pages/category.aspxhttp://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xlshttp://ishare/QMD/Folder/SKMC%20KPIs%20Dashboard/SKMC%20KPIs_JCI%20Red%20Light%20Green%20Light%20Dashboard.xls


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3 types of measuresStructure:Physical equipment and facilities

Process:How Healthcare is providedHow the system worksOutcome:Health statusDoes it make a difference?

Measurement: Process and Outcome

Indicators -How do Customers look at Quality?


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As a Patient, suppose you wanted to measure

the quality of care for a knee replacement;

consider what you could measure for each.

Structure:Are there OR

facilitiesavailable?

Process:How consistently does

the OR Process followthe policy?

Outcome:What is the

success rate?

You could consider:

A li ti f PI d l


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Application of a PI model

Structure Process Outcome

Have wereduced thelikelihood of

harm?

Are we doingwhat we aresupposed to

do?

How do weHarm?What isHarm?


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HMMMI wonder what we

measure at SKMC?


International Patient


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International Patient

Safety Goals

"If you can't measure it you can't manageit 63


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Unit Specific KPIs


HA AD Patient Safety Goals
http://ishare/Nursing/Nursing%20Monthly%20Reports/Forms/current.aspx?RootFolder=/Nursing/Nursing%20Monthly%20Reports/2011%20Monthly%20Report/Critical%20Care%20_%20Heart%20and%20Vascular%20Surgery%20Institute/C4%20Cardiac%20and%20Transplant%20IC


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HA-AD Patient Safety Goals

1. Improve the accuracy of patient identification2. Improve the effectiveness of communication among care

givers and care recipients3. Improve the safety of using medications and medical devices4. Reducing the risk of healthcare associated infections5. Ensuring correct site, correct procedure, correct patient for

all procedures6. Accurately and completely reconcile medications across the

continuum of care7. Encourage patients active involvement in their own care as a

patient safety strategy8. Improve recognition and response to changes in a patients condition9. Reducing risk of patient harm resulting from falls

10. Reduce the risk of hospital fires

"If you can't measure it you can't manage

it 65


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Core Measure Sets

(Clinical Starter Sets)

Wh t i ?


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What is a core measure?

They are standardized evidence

basedperformance measures

They are PROCESS measures (howrecommended care is provided)

The core measure results are reported toSEHA

Results can be tied to$$$$$$ REIMBURSEMENT $$$$$$


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Clinical Starter Sets(Core Measure Sets)


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Clinical Starter sets are here to stay.

Quality Measures enables us to not only pinpoint and address

quality-of-care issues, but also spot and correct data-collection

problems.

Core Measures are like practice standards that guide us to give

the best possible care.

These standards challenge us to re-evaluate the way we

coordinate and deliver care. For example, improved teamwork

and communication can lead to 100% of STEMI patients

receiving PCI within 90 minutes of arrival at the hospital.

Clinical Starter Sets

Goals of NDNQI


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Goals of NDNQI

Providecomparativeinformation tohospitals for use

in qualityimprovementactivities

Develop national

data on therelationshipbetween nurse

staffing andpatient outcomes

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Data Model


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Data Model Adapted Donabedians conceptual framework

Structure Measures of quantity and quality of nursing staff

Hospital characteristics like Magnet recognition,teaching status, bed size, etc.

Process Measure aspects of nursing care

(assessment/intervention)

Outcome Patient outcomesrelated to quantity or quality of

nursing careA. Donabedian, The Quality of Care, JAMA1988:260 (12):1743-1748

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NDNQI Data Collection


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Patient falls -As it occursPatient falls with injury-As above

Pressure ulcers:- Snapshot, all pts on the unit at the

time once per month

Community acquired

Hospital acquired

Unit acquiredStaff mix - Monthly

Nursing hours per patient dayMonthly

Patient Days- Monthly

RN Surveys: - Annually

Job satisfaction- AnnuallyPractice environment scale

NDNQI Data Collection

Methodology


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Pediatric pain assessment cycle -Snapshot, all pts on the

unit at the time once per month

Pediatric IV infiltration rate-Snapshot, all pts on the unit atthe time once per month

Restraints prevalence-Snapshot, all pts on the unit at the

time once per month

Nurse turnover- Monthly

RN Education & Certification - Quarterly

Nosocomial infections:-

-Ventilator-assisted pneumonia VAP)

-Central line associated blood

stream infection (CLABSI)

-Catheter associated urinary

tract infections (CAUTI)

Monthly

Final word on PI


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Final word on PI

Every person in the organization has an

influence on certain KPIs and PI

KPIs do NOT give answers, rather they raise

questions and direct attention.

Structure, Process and Outcomes ( think like

the customer)


QUALITY IS EVERYBODYs

BUISNESS

4 key traits for


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1. Nurses must be actively involved..

2. Quality outcomes should be visible.

3. Support

4. Promote autonomy and accountability.

4 key traits for

outstanding nursing quality

Strong leadersh ip, Teamwork , Comm itment

to ongoing imp rovement in pat ient care

Qual i ty, Con t inuous s taff educat ion , and

Efficient use of resources.

BUILDING A HOUSE OF QUALITY


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BUILDING A HOUSE OF QUALITY

CONTINUOUSIMPROVEMENT

Thevo

iceo

fthe

Pa

tien

t

HIGHEXPEC

TATIONS

INVOLVE

MENT

ASSESSM

ENT&

FEEDBAC

K

SHARED VALUES AND GOALS/ OBJECTIVES

TRUST

MANAGEMENT BUY-IN



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KPI Presentation 2012 . Pptx

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