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Six Tips for Measuring Hospitalist Program Performance

Liz Jones, July 19, 2010

If you resolve to lose weight, you might count calories, log your workouts, measure your waistline, and weigh yourself on a scale. These four activities help you keep track of your progress. If you don't measure them, you would have no idea whether your hard work was paying off. Worse, without the reward of seeing a lower weight on the scale or that extra mile logged per week, you might become disenchanted and ditch your effort altogether.

The same concept holds true for hospitalist programs. They must measure their performance regularly to gauge whether they are making any progress toward their improvement initiatives. Despite the inherent benefits of tracking progress, 30-50% of hospitalist programs don't use them, says John Nelson, MD, FACP, partner at Nelson Flores, LLC, a hospitalist consulting firm based in Bellevue, WA.

The time it takes to design a meaningful, easy-to-use dashboard can seem overwhelming for hospitalists who already have full-time clinical and/or academic responsibilities, but here are some tips to help you get started:

Don't get hung up on perfection

Hospitalist program leaders won't develop the perfect program dashboard out of the gate, says Nelson. Consider the dashboard a living document that will need to be updated regularly with new types of quality metrics to reflect the program's current goals. The goal is to gain an accurate—not exact—idea of how your program is performing.

Gather data that is already being reported

There is no need to reinvent the wheel if you want to create a useful hospitalist program dashboard. The ED, already collects information, for example, about admissions from the ED, and the pharmacy has data on the medications ordered by the hospitalists. Figure out what your hospital is already collecting, and use that data as the foundation for your dashboard.

Contact your decision support department (otherwise known as the information services or information technology department) to request specific information, such as hospitalist admission rates. Decision support can often set up a system to populate certain items in the dashboard automatically.

Keep in mind though that gathering data shouldn't consume too much of a hospitalist program leader's time. "Don't create a dashboard that requires you to spend hours every month collecting and abstracting the data yourself," says Nelson.

Keep it simple

Keep the dashboard focused on the handful of measures that are relevant and important to your program. How do you know if you have too many measures on your dashboard? Hospitalists can't rattle them off without looking. "If you can't, from memory, say every element that is on the dashboard, you probably have too many. You don't have to know the numbers, but you should know what is being measured," says Nelson.

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