NAPH-UHC Clinical Improvement Tools NAPH Annual Conference June 20, 2002 David Burnett, MD, MPH

© 2002 University HealthSystem ConsortiumNAPH 6-19-02 UHC Improvement Tools.ppt1

NAPH-UHC Clinical Improvement ToolsNAPH-UHC Clinical Improvement ToolsNAPH Annual ConferenceNAPH Annual ConferenceJune 20, 2002June 20, 2002

David Burnett, MD, MPHDavid Burnett, MD, MPH

NAPH Annual ConferenceNAPH Annual ConferenceJune 19-22, 2002June 19-22, 2002


UHC Information Tools to Support UHC Information Tools to Support Quality, Safety, and Efficiency Quality, Safety, and Efficiency

ImprovementImprovement• Clinical Data ProductsClinical Data Products• Patient Safety NetPatient Safety Net• Faculty Practice Solutions CenterFaculty Practice Solutions Center• Operational Data BaseOperational Data Base• Benchmarking Benchmarking


Comparative Clinical Data Offerings:Comparative Clinical Data Offerings:A Source of Descriptive Data A Source of Descriptive Data


Clinical Information Management Provides a Clinical Information Management Provides a Suite of ServicesSuite of Services

• Clinical Data Base (CDB)Clinical Data Base (CDB)

• JCAHO ORYX Reporting JCAHO ORYX Reporting

• CDB-PharmacyCDB-Pharmacy

• State DatabasesState Databases

• MEDPAR AnalysesMEDPAR Analyses

• Custom Analytic ServicesCustom Analytic Services


The UHC Clinical Data Base Provides The UHC Clinical Data Base Provides Comparative Data on Peer Academic Medical Comparative Data on Peer Academic Medical

CentersCenters

• CDB pools clinical and financial data using discharge abstract CDB pools clinical and financial data using discharge abstract summaries and UB-92 datasummaries and UB-92 data

• Key Outcomes: Key Outcomes: Cost, LOS, Mortality, Complications, Cost, LOS, Mortality, Complications, Components of CostComponents of Cost

• CDB data is CDB data is fully risk-adjustedfully risk-adjusted

• CDB provides CDB provides cost estimatescost estimates, not charges, not charges


UHC Product LinesUHC Product Lines

BMT

BURNS

CARDIOLOGY

CARDIOTHORACIC SURGERY

DENTAL/ORAL SURGERY

DERMATOLOGY

GASTROENTEROLOGY

GYNECOLOGY

HEART TRANSPLANT

HIV

KIDNEY TRANSPLANT

LIVER TRANSPLANT

LUNG TRANSPLANT

MED ONCOLOGY

MEDICINE GENERAL

NEONATOLOGY

NEUROLOGY

NEUROSURGERY

The 500+ DRGs have been assigned to 36 product lines

RHEUMATOLOGYSUBSTANCE ABUSESURG ONCOLOGYSURGERY GENERALTRAUMAUNGROUP/INVUROLOGYVASCULAR SURGERYVENTILATOR SUPPORT

NORMAL NEWBORNSOBSTETRICSOPHTHALMOLOGYORTHOPEDICSOTOLARYNGOLOGYPEDIATRICSPLASTIC SURGERYPSYCHIATRYREHABILITATION


Web interface allows wide access throughout the institution


UHC Clinical Data Base ORYX Core Measure UHC Clinical Data Base ORYX Core Measure ServiceService

Online data entry tool or data upload capabilityOnline data entry tool or data upload capability

Online reporting tool for Quality/Performance Improvement Online reporting tool for Quality/Performance Improvement reviewsreviews

Control chart creation for easy review of case data pointsControl chart creation for easy review of case data points


CDB-Pharmacy CDB-Pharmacy Report Generation (Examples)Report Generation (Examples)

1.1. What are my top generic drugs within a product line or DRG?What are my top generic drugs within a product line or DRG?

2.2. Where is Drug A being used most in the hospital?Where is Drug A being used most in the hospital?

3.3. What % of my CABG pts receive albumin compared to other HCOs?What % of my CABG pts receive albumin compared to other HCOs?

4.4. Which glycoprotein iib/iiia inhibitors are other HCOs using in the Which glycoprotein iib/iiia inhibitors are other HCOs using in the cardiology product line?cardiology product line?

5.5. What anticoagulants (DVT prophyx) are other HCOs using in pts What anticoagulants (DVT prophyx) are other HCOs using in pts undergoing total hip replacement (THR)?undergoing total hip replacement (THR)?

6.6. Which physicians are using more antifungals in the BMT pt group?Which physicians are using more antifungals in the BMT pt group?


The UHC Patient Safety NetThe UHC Patient Safety Net


Toward an Epidemiology of SafetyToward an Epidemiology of Safety

• Focus on actual or potential harm to patients, not errorFocus on actual or potential harm to patients, not error

• Approaches tailored to the problemApproaches tailored to the problem

– Root cause analysis for rare, serious eventsRoot cause analysis for rare, serious events

– Data analysis for more common, less serious eventsData analysis for more common, less serious events

• Measurement is the beginning of managementMeasurement is the beginning of management

– Establishing run rates for most common events Establishing run rates for most common events

– Identifying areas for more focused process Identifying areas for more focused process improvement effortsimprovement efforts


Design of the Patient Safety NetDesign of the Patient Safety Net

• Internet based (server at UHC in Chicago)Internet based (server at UHC in Chicago)

• Point of care data entry for adverse events & near missesPoint of care data entry for adverse events & near misses

• Simple common classification systemSimple common classification system

• Rapid event reportingRapid event reporting

• Fields for medication errors, ADR’s, falls, transfusion Fields for medication errors, ADR’s, falls, transfusion events, procedural events, complications, equipment events, procedural events, complications, equipment issues, behavioral events, skin integrity, otherissues, behavioral events, skin integrity, other

• Secondary (password protected) fields for analysis of Secondary (password protected) fields for analysis of events by nursing, pharmacy, quality/risk managementevents by nursing, pharmacy, quality/risk management


Special Features of the DatabaseSpecial Features of the Database

• Patient, visitor, staff and other events capturedPatient, visitor, staff and other events captured

• ““Close call” or “near miss” reportingClose call” or “near miss” reporting

• Anonymous reporting an optionAnonymous reporting an option

• Customized site of care fieldsCustomized site of care fields

• Customized e-mail alert functionsCustomized e-mail alert functions

• Standardized and custom reportsStandardized and custom reports

• Field for legal disclaimerField for legal disclaimer

• Comparative data for benchmarking, detecting trendsComparative data for benchmarking, detecting trends


May 21, 2002

UHC-AAMC Faculty Practice Solutions Center Introduction and Overview


• Facilitate the open sharing of practice management and physician Facilitate the open sharing of practice management and physician productivity data across institutionsproductivity data across institutions

• Develop and provide access to statistically valid and stable comparative Develop and provide access to statistically valid and stable comparative benchmarking data (physician productivity, departmental finance and benchmarking data (physician productivity, departmental finance and operations, billing office performance)operations, billing office performance)

• Provide easy to use tools for clinical activity reporting and analysisProvide easy to use tools for clinical activity reporting and analysis

• Facilitate knowledge transfer and experience sharing among academic Facilitate knowledge transfer and experience sharing among academic practice managerspractice managers

• Provide access to UHC, AAMC, and third-party content on practice Provide access to UHC, AAMC, and third-party content on practice management issuesmanagement issues

Objectives of the Faculty Practice Solutions Center


FPSC Features and AttributesFPSC Features and Attributes

• 50+ participating organizations (30,000+ MDs)50+ participating organizations (30,000+ MDs)

• 5+ consecutive years of MD-level CPT billing data5+ consecutive years of MD-level CPT billing data

• Menu of routine and custom comparative reports/analyses, provided Menu of routine and custom comparative reports/analyses, provided on a quarterly basison a quarterly basis

• Custom benchmarkingCustom benchmarking

• On-site training/implementation assistanceOn-site training/implementation assistance

• UHC, AAMC, and syndicated content for MD and practice UHC, AAMC, and syndicated content for MD and practice management educationmanagement education

• Community of users on lineCommunity of users on line


Design of the FPSC

Member Concern:Member Concern:

• existing comparative data not existing comparative data not reflective of AHC faculty groupsreflective of AHC faculty groups

• inaccuracies of “survey” datainaccuracies of “survey” data

• missing or misclassified datamissing or misclassified data

• significant year to year variability in significant year to year variability in existing comparative dataexisting comparative data

FPSC Approach:FPSC Approach: numerous faculty groups participatingnumerous faculty groups participating broad scope of specialties broad scope of specialties continuous feedback and refinement through continuous feedback and refinement through

member involvementmember involvement data submitted electronicallydata submitted electronically consistent methodology in RVU calculationconsistent methodology in RVU calculation

individual MD detail allows exclusion of individual MD detail allows exclusion of outliers and analysis of coding behaviorsoutliers and analysis of coding behaviors


UHC-AAMC FPSC ParticipantsUHC-AAMC FPSC Participants• Alabama Alabama • Albert Einstein/MontefioreAlbert Einstein/Montefiore• ArizonaArizona• Arkansas *Arkansas *• Baystate/TuftsBaystate/Tufts• ChicagoChicago• CincinnatiCincinnati• Cleveland Clinic *Cleveland Clinic *• ColoradoColorado• ConnecticutConnecticut• DukeDuke• East CarolinaEast Carolina• Emory *Emory *• FloridaFlorida• George Washington *George Washington *• GeorgiaGeorgia• Harlem HospitalHarlem Hospital• Harvard/Beth Israel-DeaconessHarvard/Beth Israel-Deaconess• Harvard/Brigham and Women's Harvard/Brigham and Women's • Harvard/Mass GeneralHarvard/Mass General• IndianaIndiana

• IowaIowa• Johns Hopkins *Johns Hopkins *• KansasKansas• Kentucky *Kentucky *• Loyola-StritchLoyola-Stritch• MarylandMaryland• UMassUMass• Med University of So CarolinaMed University of So Carolina• Medical College of WisconsinMedical College of Wisconsin• Michigan *Michigan *• Missouri-ColumbiaMissouri-Columbia• Missouri-Kansas CityMissouri-Kansas City• Mt Sinai (NYC) *Mt Sinai (NYC) *• NebraskaNebraska• New MexicoNew Mexico• North CarolinaNorth Carolina• NorthwesternNorthwestern• Ohio StateOhio State• Oklahoma *Oklahoma *• OregonOregon• PennsylvaniaPennsylvania• RochesterRochester

• Sinai of Baltimore *Sinai of Baltimore *• South FloridaSouth Florida• Stanford *Stanford *• SUNY-Stony BrookSUNY-Stony Brook• Tufts (NEMC) *Tufts (NEMC) *• UC-Los Angeles *UC-Los Angeles *• UC-San DiegoUC-San Diego• USAF Surgeon GeneralUSAF Surgeon General• Utah *Utah *• UT-GalvestonUT-Galveston• VanderbiltVanderbilt• Vermont Vermont • VirginiaVirginia• Virginia CommonwealthVirginia Commonwealth• Wake ForestWake Forest• Washington University-St Louis *Washington University-St Louis *• West Virginia West Virginia • Wisconsin *Wisconsin *• YaleYale

* department-level participant


Automated Electronic Transfer Allows Automated Electronic Transfer Allows Efficient Data CaptureEfficient Data Capture

FPSC participants send physician-level billing data to UHC. Data is electronically extracted and sent from the billing office.

Total Billings for ea. Procedure

Data In (at the procedure-level):

CPT Code for the Procedure

CPT Code Modifiers

Frequency of Billed Procedure

Site of Service for ea. Procedure

Payer Class for ea. Procedure

ICD-9 Codes (first four)

Service Data & Posting Date

Patient Demographics Data: age, sex, race, zip code


Converting Data to Management Support

Data Out:

UHC Processes, Validates, and Converts

the Data into Practice Management

Measurements

Total and Work RVUs

Billed Charges

Productivity by Service Mix & Payer Class

Physician & Department-Level Productivity


Benchmark Specialties• AnesthesiologyAnesthesiology• DermatologyDermatology

• General DermatologyGeneral Dermatology• MOHS SurgeryMOHS Surgery

• Emergency MedicineEmergency Medicine• Family PracticeFamily Practice• Human GeneticsHuman Genetics• Internal MedicineInternal Medicine

• GeneralGeneral• Allergy/ImmunologyAllergy/Immunology• Bone Marrow TransplantBone Marrow Transplant• CardiologyCardiology

InvasiveInvasive Non-invasiveNon-invasive

• Critical CareCritical Care• Endocrinology/ MetabolismEndocrinology/ Metabolism• GastroenterologyGastroenterology• GeriatricsGeriatrics• Hematology/ OncologyHematology/ Oncology• Infectious DiseaseInfectious Disease• NephrologyNephrology• Occupational MedicineOccupational Medicine• Pulmonary DiseasePulmonary Disease• RheumatologyRheumatology

• NeurologyNeurology

• OB/GYN• General• Gynecological Oncology• Maternal and Fetal

Medicine• Reproductive Endocrinology• Urogynecology

• Ophthalmology• Otorhinolaryngology • Pathology

• Anatomic• Clinical• Surgical

• Pediatrics• General• Allergy/Immunology• Cardiology• Critical Care• Endocrinology• Gastroenterology• Hematology/Oncology• Infectious Disease• Neonatal Medicine• Nephrology• Neurology• Psychiatry• Pulmonology• Surgery

• Physical Medicine• Physical Therapy

• Psychiatry• Radiology

• Diagnostic• Interventional• Nuclear Medicine

• Radiology Oncology• Surgery

• Cardiovascular• Colon/Rectal• General• Hand• Neurological• Oral• Orthopedic• Plastic• Sports Medicine• Vascular/Thoracic

• Transplant Surgery• Heart• Kidney• Liver

• Urology


Web-based tool provides Web-based tool provides flexible and interactive reporting.flexible and interactive reporting.


What Other Measures Does the FPSC Provide?

• Evaluation and Management (E&M) Coding DistributionEvaluation and Management (E&M) Coding Distribution

• Scope and Mix of Services (Clinical Fingerprint)Scope and Mix of Services (Clinical Fingerprint)

• Charge Lag AnalysisCharge Lag Analysis

• Charge Summary StatisticsCharge Summary Statistics

• Revenue ForecastingRevenue Forecasting

• Custom Peer Cohort BenchmarkingCustom Peer Cohort Benchmarking

• OthersOthers


FPSC Use in Safety Net Institutions Dealing with Similar Issues

• Harlem physician staffing assessmentHarlem physician staffing assessment

– Developed safety net benchmark groupDeveloped safety net benchmark group

– Assessed clinical workload/productivityAssessed clinical workload/productivity

– Evaluated barriers to enhanced productivityEvaluated barriers to enhanced productivity

– Recommended system for ongoing management of physician Recommended system for ongoing management of physician productivityproductivity


Barriers to Realizing Productivity Enhancement Opportunities

• Barriers common in Safety Net institutionsBarriers common in Safety Net institutions

– Variable operational support and resourcesVariable operational support and resources

– Shortage of nursing and clinical support staffShortage of nursing and clinical support staff

– Legacy information systemsLegacy information systems

– Lack of clinical and operational integrationLack of clinical and operational integration

– High patient no-show ratesHigh patient no-show rates


FPSC Provides Tool to Help Inform Practice Management

• Data and reports useful input toData and reports useful input to

– measure and manage productivitymeasure and manage productivity

– monitor coding compliancemonitor coding compliance

– evaluate physician workforce sizingevaluate physician workforce sizing

• Can be used in conjunction with other UHC tools Can be used in conjunction with other UHC tools to address/overcome identified productivity barriersto address/overcome identified productivity barriers


Operational Data Base Program Operational Data Base Program OverviewOverview

THE POWER OF COLLABORATION

University HealthSystem University HealthSystem ConsortiumConsortium


Operational Data Base ProgramOperational Data Base Program

• A data base reporting system and related services designed to provide A data base reporting system and related services designed to provide UHC members and associate members with comparative operational data. UHC members and associate members with comparative operational data.

– Focuses on operational characteristics of hospital departments (i.e., Focuses on operational characteristics of hospital departments (i.e., hours worked/unit of service, skill mix, labor and supply expense/unit of hours worked/unit of service, skill mix, labor and supply expense/unit of service, and operational practices).service, and operational practices).

– Provides information for analyses to support performance Provides information for analyses to support performance improvement, budgeting, cost reduction, and identification of best improvement, budgeting, cost reduction, and identification of best performersperformers

– Creates direct networking opportunities among UHC participants and Creates direct networking opportunities among UHC participants and between UHC participants and non-UHC participants*between UHC participants and non-UHC participants*

– Facilitates the tracking of key performance measures resulting from Facilitates the tracking of key performance measures resulting from UHC operational benchmarking projectsUHC operational benchmarking projects

*There are 59 UHC members and approximately 450 non-UHC participants in *There are 59 UHC members and approximately 450 non-UHC participants in the data base.the data base.


Program ParticipantsProgram Participants• UAB Health System

• University Hospital of Arkansas*

• UCLA Healthcare

• UCSF

• Stanford Health Care

• UC San Diego Medical Center (2)

• San Joaquin General Hospital*

• Santa Clara County*

• Denver Health*

• Georgetown University Hospital

• Shands HealthCare

• Tampa General

• Crawford Long Hospital of Emory University

• Emory University Hospital

• Medical College of Georgia

• Grady Health System*

• University of Iowa Hospitals and Clinics

• University of Chicago Hospitals*

• University of Illinois at Chicago Medical Center

• Loyola University Medical Center

• Wishard Health Services

• University of Kansas Hospital

• Brigham and Women’s Hospital

• UMass Memorial Health Care

• University of Michigan Health System

• Hennepin County Medical Center*

• Fairview University (MN) Medical Center

• University of Missouri Health Care*

• University Medical Center of Southern Nevada*

• University for Medicine and Dentistry of New Jersey*

• University of New Mexico Hospital*

• SUNY Health Science Center at Syracuse

• University Hospital and Medical Center at Stony Brook

• New York Presbyterian (3)

• University Health Systems of Eastern Carolina

• University of North Carolina Hospitals

• Wake Forest Baptist Medical Center

• Medical College of Ohio

• UHHS University Hospitals of Cleveland

• Oregon Health Sciences

• Thomas Jefferson

• Methodist Hospital Division, TJUH

• University of Pennsylvania Health System (4)

• Penn State – Hershey Medical Center

• Medical University of South Carolina

• Vanderbilt Medical Center

• Methodist Hospital (Houston)

• University of Texas Medical Branch, Galveston*

• University of Virginia Health System

• VCU Health System Authority*

• Harborview Medical Center*

• Froedtert Memorial Lutheran Hospital

• University of Wisconsin Hospital and Clinics

*NAPH members*NAPH members


HBSI ACTION Highlights*HBSI ACTION Highlights*

• PC based software to support on-site data collection, reporting and PC based software to support on-site data collection, reporting and analysis; migrating to web in 2003analysis; migrating to web in 2003

• Quarterly staff and expense performance information using standardized Quarterly staff and expense performance information using standardized data collection instruments data collection instruments

• Up to nine quarters of data from over 500 institutions including more than Up to nine quarters of data from over 500 institutions including more than 50 UHC members50 UHC members

• Standard and user-defined cost center and facility reports which enable Standard and user-defined cost center and facility reports which enable the user to customize analyses the user to customize analyses

• Quarterly enhancements of methodologies, software and/or product Quarterly enhancements of methodologies, software and/or product documentationdocumentation

• Includes UHC data starting first quarter 1998Includes UHC data starting first quarter 1998

*The HBSI ACTION and PEERnext products will be combined in 2003 *The HBSI ACTION and PEERnext products will be combined in 2003 resulting in more data collection tools and greater participation.resulting in more data collection tools and greater participation.


Functional Areas within HBSI ACTIONFunctional Areas within HBSI ACTION

• Admitting/Patient Care Registration

• AM Admission

• Ambulatory Surgery

• Anesthesia Department

• Biomedical Engineering

• Cardiology-Invasive

• Cardiovascular Non-Invasive Diag

• Community Education

• Dental Clinic

• Education Services

• Electrodiagnostics

• Emergency Department

• Endoscopy/G.I. Lab

• Environmental Services

• Facility Information

• Financial Information

• Food & Nutritional Services

• General Accounting

• Health Information/Medical Records

• Home Health Care (4 departments)

• Hospital Administration

• Human Resources

• Imaging Services (six modalities)

• Information Systems

• Labor and Delivery

• Laboratory

• Laundry/Linen

• Marketing/Planning/Public Relations

• Materials Management

• Neurodiagnostics

• Nursing Administration

• Operating Room

• Orthotics & Prosthetics Services

• Outpatient Clinics (32 clinics)

• Outpatient Observation Unit

• Partial Hospitalization Unit

• Patient Accounting

• Patient Care Units (70+ units)

• Pharmacy

• Physician Practice

• Plant Operations/Maintenance

• Post Anesthesia Care Unit

• Radiation Oncology

• Rehab (5 departments)

• Respiratory Care

• Security

• Sleep Lab

• Social Services

• Sterile Processing

• Telecommunications

• Utilization Review


Standard Elements Reported at the Standard Elements Reported at the Department LevelDepartment Level

StatisticsStatistics

• Worked HoursWorked Hours

• Paid Hours Paid Hours

• OvertimeOvertime

• Paid Time Off PercentagePaid Time Off Percentage

• Salary Cost (including skill Salary Cost (including skill mix)mix)

• Supply Cost Supply Cost

• Direct Cost Direct Cost

• Workload (I.e., Patient Days, Workload (I.e., Patient Days, LOS, Billed Tests, OR Hours, LOS, Billed Tests, OR Hours, ED Visits, Adjusted ED Visits, Adjusted Discharges, etc.)Discharges, etc.)

CharacteristicsCharacteristics

• Do you send staff home when the Do you send staff home when the census is low?census is low?

• Are ED observation patients held in Are ED observation patients held in the ED or sent to an observation unit?the ED or sent to an observation unit?

• What percentage of your Neonates What percentage of your Neonates are born <1,500 gramsare born <1,500 grams

• What is your level of product What is your level of product standardization for select cases?standardization for select cases?

• Do you utilize protocols?Do you utilize protocols?


Use of ODB Data By UHC Members Use of ODB Data By UHC Members

• Majority of members are using data for budgeting/cost reduction:Majority of members are using data for budgeting/cost reduction:

– Fifty-two percent will use the data for FY2003 budgetingFifty-two percent will use the data for FY2003 budgeting

– Ninety-one percent will use the data for budgeting and/or targeting Ninety-one percent will use the data for budgeting and/or targeting areas for cost reductionareas for cost reduction

• A variety of methods have been used:A variety of methods have been used:

– The 25th or 50th percentile across the board for all departmentsThe 25th or 50th percentile across the board for all departments

– Target the 10 departments with the largest opportunities each quarterTarget the 10 departments with the largest opportunities each quarter

– Sliding targets based on the respective department’s performance (i.e., Sliding targets based on the respective department’s performance (i.e., 40th percentile if at the 50th percentile, 60th percentile if at the 70th 40th percentile if at the 50th percentile, 60th percentile if at the 70th percentile, etc.) percentile, etc.)


UHC Makes Extensive Use of ODB UHC Makes Extensive Use of ODB Data in Support of Members’ Data in Support of Members’

Improvement InitiativesImprovement Initiatives

• Key Indicator ReportKey Indicator Report

• Integrated ReportIntegrated Report

• Operational BenchmarkingOperational Benchmarking

• Department specific analysesDepartment specific analyses

• Value Analysis ProgramValue Analysis Program

• Novation ParticipationNovation Participation

• Member Specific Engagements Related to Supply Chain ManagementMember Specific Engagements Related to Supply Chain Management

• Member Advocate ProgramMember Advocate Program


UHC Benchmarking Program UHC Benchmarking Program OverviewOverview


UHC BenchmarkingUHC Benchmarking

Do Things RightDo Things Right

Care delivery and Care delivery and supportsupport

• Process-focusedProcess-focused• Unit cost Unit cost

managementmanagement• Elimination of Elimination of

process defectsprocess defects• Efficiency Efficiency

optimizationoptimization

Clinical decision makingClinical decision making• Procedure/condition Procedure/condition

focusedfocused• Utilization Utilization

managementmanagement• Variation minimizedVariation minimized• Clinical practice Clinical practice

advancementadvancementDo the Right Do the Right ThingThing

OperationalOperationalBenchmarkingBenchmarkingOperationalOperational

BenchmarkingBenchmarkingClinicalClinical

BenchmarkingBenchmarkingClinicalClinical

BenchmarkingBenchmarking

High-QualityHigh-QualityEfficientEfficient

Patient CarePatient Care

High-QualityHigh-QualityEfficientEfficient

Patient CarePatient Care


UHC Model for Managing ValueUHC Model for Managing Value

* * Completed Completed FutureFuture‡ ‡ Joint clinical/operationalJoint clinical/operational

benchmarking projectbenchmarking project

Patient Accounting *Patient Accounting *Laboratory *Laboratory *Surgical Services **Surgical Services **‡ †‡ † Employee Benefits *Employee Benefits *Imaging *Imaging *Emergency Department *Emergency Department *Adult ICU Phases I and II *Adult ICU Phases I and II *Purchasing Process *Purchasing Process *Ambulatory Clinics *Ambulatory Clinics *Medication Use Process *Medication Use Process *Medical Records *Medical Records *Trauma *Trauma *Health Info. Technology *Health Info. Technology *Inpatient Admitting *Inpatient Admitting *Customer Service *Customer Service *Clinics Organization andClinics Organization and

Registration *Registration *

Kidney Transplant*Kidney Transplant*CABG*CABG*PTCA*PTCA*Hip Replacement*Hip Replacement*Bone Marrow Bone Marrow

Transplant*Transplant*StrokeStrokeCongestive HeartCongestive Heart

Failure*Failure*Trauma *Trauma *AMI Core Measure AMI Core Measure

IntegrationIntegration††Diabetes*Diabetes*††Heart Transplant*Heart Transplant*Pediatric Asthma*Pediatric Asthma*Adult Asthma*Adult Asthma*

Community-Acquired Community-Acquired Pneumonia*Pneumonia*

Acute MI*Acute MI*NeonatologyNeonatologyHIV/AIDS HIV/AIDS Cardiology Cardiology

ImplementationImplementation ‡ ‡ Adult ICU Follow-upAdult ICU Follow-up††‡‡Small & Large BowelSmall & Large Bowel††Transplant ServicesTransplant Services† ‡ † ‡

Women’s Health *Women’s Health *Pediatrics *Pediatrics *Complementary Medicine *Complementary Medicine *Performance Improvement Models *Performance Improvement Models *Medical Records Follow-up *Medical Records Follow-up *Cardiology*Cardiology*Supply Cost Management* Supply Cost Management* Claims Denials*Claims Denials*Imaging Services *Imaging Services *Clinics Billing and Coding *Clinics Billing and Coding * Managing Patient Flow *Managing Patient Flow *Blood and Blood Products Blood and Blood Products ‡ ‡

IP Charge Capture, Bill.and Collect. IP Charge Capture, Bill.and Collect. Leadership and Mgmt Dev. Leadership and Mgmt Dev. Use of Decision Support ToolsUse of Decision Support Tools††

Value = Quality, CostValue = Quality, CostValue = Quality, CostValue = Quality, Cost

BenchmarkingBenchmarking

††

‡‡

‡‡

OperationalOperationalClinicalClinical


Gather data fromGather data fromyour organizationyour organizationand from “best-in-class”and from “best-in-class”• SurveySurvey• Site visitsSite visits

Benchmarking ProcessBenchmarking Process

IdentifyIdentifyrelevantrelevantperformanceperformancedatadata

DetermineDetermineprocess(es)process(es)to be to be studiedstudied

Compare/Compare/discoverdiscover

“best-in-class”“best-in-class”enablersenablers

Regularly monitor Regularly monitor performanceperformance

Adopt/Adopt/adaptadapt

selected selected enablersenablers


Benchmarking Project OutputsBenchmarking Project Outputs

• Project Summary (web and written) Project Summary (web and written)

• Performance Opportunity Summaries Performance Opportunity Summaries

• Knowledge Transfer Meeting MaterialsKnowledge Transfer Meeting Materials

• Survey Results Survey Results

• Customized Satisfaction Survey Results (select projects)Customized Satisfaction Survey Results (select projects)

• Case StudiesCase Studies

• Implementation Strategies and SupportImplementation Strategies and Support

Information is accessible through the UHC Web Site (Information is accessible through the UHC Web Site (www.uhc.eduwww.uhc.edu under Improvement and Effectiveness) under Improvement and Effectiveness)

NAPH-UHC Clinical Improvement Tools NAPH Annual Conference June 20, 2002 David Burnett, MD, MPH

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Transcript of NAPH-UHC Clinical Improvement Tools NAPH Annual Conference June 20, 2002 David Burnett, MD, MPH