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Healthcare Quality Metrics and Leadership

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0% found this document useful (0 votes)
14 views34 pages

Healthcare Quality Metrics and Leadership

Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Prepared by

Aysha Al-Quda RN
Supervised by
Ali Saleh, PhD, RN
Outline
Introduction

Quality Measures & Metrics

Quality Assurance, Quality Control, and


Quality Improvement
Leadership, Measurement, and Improvement

Keys to Success

Conclusion
Objectives
After the end of this presentation each student will be
able to:
 Discuss the importance of quality measures & metrics.
 Differentiate between dashboards & scorecards.
 List the key characteristics of quality assurance, quality
control, and quality improvement.
 Mention the essential high impact leadership behaviors.
 Understand measures aligned to function.
 Discuss the keys to success of healthcare organization.
Introduction
Creating alignment is a critical leadership function.

Poorly articulated, non-measurable quality aims

generally lead to poor execution.


Improving quality, patient safety, patient experience,

and clinical care begin with clearly articulated and


measurable quality aims.
Quality Measures & Metrics
 Used to support internal quality improvement efforts, meet
the demands of external accreditation agencies, health
insurance companies, and government payment programs.
Example of accreditation agencies is The Joint Commission.

Example of payment programs is the Centers for Medicare &

Medicaid Services (CMS)


Quality Measures & Metrics
 Types of payment systems incorporate traditional fee-for-
service models & value-based payment models.
Value-based payment is depend on the achievement of

measure-based quality goals.


Both government programs and private health insurance

payment systems are moving toward value-based payment


programs.
Quality Measures & Metrics
Transparency about quality and performance is important to

pay closer attention to important indicators and to provide


consumers with the information they need to make better
healthcare purchasing decisions.
Many people in the healthcare field consider the public

reporting of performance data as a questionable regulatory


process hat does not necessarily provide a meaningful
reflection of an organization’s performance
Commonly Used Quality-
Measurement Sets
Healthcare Effectiveness Data and Information Set (HEDIS).

 Sponsored by The National Committee for Quality Assurance

(NCQA).
 Used by more than 90 percent of US health plans and managed care

organizations.
 Collect information on whether members receive appropriate

treatment for diabetes, breast cancer, cholesterol management in heart


disease, and upper respiratory infections in children.
Dashboards
It is similar to the instrument panel on an automobile, which, when

the car is moving, enables the driver to monitor key performance


metrics such as speed, fuel level, and direction.
In the business world, dashboards are tools that report on the

ongoing performance of the critical processes that lead to


organizational success rather than on the success itself.
Scorecards
Used to record and report on periods of past performance, rather

than on real-time performance.


Reflect outcome measures rather than process measures.

They are analogous to school report cards, which are issued after

all work has been completed and use a specific grading standard.
Many organizational scorecards and dashboards contain a mix of

outcome-, strategy-, and process-related measures.


Quality Assurance, Quality
Control, and Quality Improvement
Leadership, Measurement, and
Improvement
Leadership, Measurement, and
Improvement
Leadership, Measurement, and
Improvement
Dashboards and Scorecards in a
Strategic Leadership System
Leadership in a healthcare organization is a complex system that

incorporates beliefs, values, and behaviors, as well as a series of


complex processes.
 Leadership is commonly defined or associated with individual

behaviors or characteristics
Organization has a system of leadership that is defined by the values,

behaviors, and actions of leaders—in particular, where and how they


spend their time, energy, and attention.
Dashboards and Scorecards in a
Strategic Leadership System
One of the key elements of the leadership system is the measurement

process, which includes dashboards and scorecards.


Scorecards and dashboards are useful for organizing important

metrics.
Scorecards and dashboards should drive leadership behavior and be

used to create alignment in organizations.


 Financial and volume measures have traditionally driven

management behavior in healthcare.


Organizing Measures by Category
The availability of electronic medical record and billing systems in the United

States is making it easier for healthcare delivery organizations to collect some


quality and performance measures.
Healthcare organizations traditionally sort the measures they collect into

categories such as financial, volume, satisfaction, patient safety, clinical quality,


and population health.
Some healthcare organizations have developed summary dashboards of key

indicators, organized by category, to sharpen focus and to facilitate reporting


and day-to-day management of various functions.
Organizing Measures by Category
Dashboards and scorecards may be organized in formats ranging

from simple tables to web-based graphical reports.


 Data report formats include tables, radar charts, bar graphs, run or

control charts, and color-coded indicators designed to highlight


metrics that do not meet targets or expectations.
Measures for Governance and
Leadership
Dimensions of Performance in
Healthcare
Creating an Organizational
Scorecard
The development of an organizational scorecard should involve more than

a simple transfer of existing measures into a new format or framework.


 The first step is to decide on an appropriate framework.

 Next, senior leadership and the governing body should define the

dimensions of performance that are relevant to the organization’s mission


and the results they wish to achieve.
 Then, they should select appropriate outcome measures for each of the

chosen dimensions.
Creating an Organizational
Scorecard
 The ideal cycle time for performance measurement is quarterly.

Organizations should compare their performance results to the best

levels of performance, or benchmarks, reported by similar types of


organizations.
Keys to Success
Develop a Clear Understanding of the Intended Use of scorecard or

dashboard
Engage the Governing Board in Development of Organizational

Performance Measures.
Use the Scorecard to Evaluate Organizational and Leadership

Performance.
Be Prepared to Change the Measures
Keys to Success
Make the Data Useful, Not Pretty.

Integrate the Measures to Achieve a Balanced View.

Develop Clear and Measurable Strategies.

Use Organizational Performance Dimensions to Align Efforts.

Avoid Using Indicators Based on Averages.

Develop Composite Clinical Indicators for Processes and Outcome

Indicators for Results


Keys to Success
Use Comparative Data and External Benchmarks.

Change Your Leadership System.

Focus on Results, Not on Activities.

Cultivate Transparency
Conclusion
Healthcare organizations are dependent on quality and performance

measures for regulatory and payment purposes.


 Performance is measured across multiple dimensions, including

financial performance, patient experience, clinical outcomes,


employee engagement, and patient safety
 Scorecards and dashboards are useful leadership and governance

tools for creating focus and alignment within the organization

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