Question

If you were going to build a dashboard or a balanced scorecard for a nursing home, what key performance indicators might you use? Explain and elaborate on why your suggested key performance indicators are crucial to effective financial management of a nursing home organization. Think what you would be held accountable for as a manager and develop some easy to read ratios to show history and progress to support your management objectives. Consider if this dashboard would be different if you managed a for profit versus a not for profit. What would be the different indicators and emphasis. (Think about the different missions of these organizations) Be sure to post justification from the readings to support your opinions.

Answer 1

As isimple ia iconcept ias ibalanced iscorecards iare, iorganizations istill ihave idifficulty iimplementing ithem ieffectively. iAlthough ithe ifundamental ipurpose iof ia ibalanced iscorecard iis ito iincrease ithe iorganization's ifocus ion iexecution iand iresults iby imeasuring ithose ithings ithat itruly imatter ito ithe iorganization, isome ibalanced iscorecards ibecome iso icrammed iwith idata ithat ithey ilose iall imeaning.

The ibalanced iscorecard iretains itraditional ifinancial imeasures. iBut ifinancial imeasures itell ithe istory iof ipast ievents, ian iadequate istory ifor iindustrial iage icompanies ifor iwhich iinvestments iin ilong-term icapabilities iand icustomer irelationships iwere inot icritical ifor isuccess. iThese ifinancial imeasures iare iinadequate, ihowever, ifor iguiding iand ievaluating ithe ijourney ithat iinformation iage icompanies imust imake ito icreate ifuture ivalue ithrough iinvestment iin icustomers, isuppliers, iemployees, iprocesses, itechnology, iand iinnovation."

An iexample iof ia iHospital iBalanced iScorecard itemplate iwith iKPIs, iwhere imanagement iseeks ito iimprove iclinical ipractice, iprevention iand ihealth iservices imanagement.

The iBalanced iScorecard i(BSC) iplays ian iimportant irole iin ithe imanagement iof ihealthcare iorganizations ias iit ialigns ithe imission, iobjectives iand iperformance imetrics

In ithe ihealthcare iindustry, ikey iperformance iindicators i(KPIs) iare ian iintegral itool ifor imeasuring iquality. iAccording ito ia istudy ireleased iby iBiomed iCentral, iestablishing iquality iperformance iindicators ihas ibecome iincreasingly iimportant ifor ihospitals iand imembers iof ithe ihealthcare iprofession. iIn ithe istudy, iresearchers ifound ithat imany ihospitals iaren’t iusing iKPIs ito itheir ifullest iadvantage, ipotentially icutting iinto iopportunities ifor iperformance iimprovement.

Some ibasic iKPIs ifor ihospitals iare: i

1. Average iHospital iStay: iEvaluate ithe iamount iof itime iyour ipatients iare istaying

2. Treatment iCosts: iCalculate ihow imuch ia ipatient icosts ito iyour ifacility

3. Hospital iReadmission iRates: iTrack ihow imany ipatients iare icoming iback

4. Patient iWait iTime: iMonitor iwaiting itimes ito iincrease ipatient isatisfaction

5. Patient iSatisfaction: iAnalyze ipatient isatisfaction iin idetail

6. Patient iSafety: iPrevent iincidents ihappening iin iyour ifacility

7. ER iWait iTime: iIdentify irush ihours iin iyour iemergency iroom

8. Costs iby iPayer: iUnderstand ithe itype iof ihealth iinsurance iof iyour ipatients

1.                 Average iHospital iStay

The iAverage iLength iof iStay iin ihospital iis ia ipretty istraight-forward iKPI, ias iit imeasures ithe itime ispent, ion iaverage, iby ia ipatient iaccepted iin ithe ifacility. iThis ihealthcare imetric iis ia ivery igeneral ione iand ican ivary igreatly iaccording ito ithe itype iof istay iit imeasures: ia iheart itransplant isurgery iwill iincrease ithe ifigure iwhile ia iwisdom iteeth iremoval iwill ido ithe iopposite. iThis iis iwhy iit iis iinteresting ito ibreakdown ithis iKPI iin idifferent icategories iof istay, iprocedures iand ioperations iundertaken, iso ias ito ihave ia imore iaccurate iresult. iYou ican ialso imeasure iit idepending ion ithe idifferent iunits iof iyour ihospital. i

i

Performance iIndicators. iAfter idifferent ievaluations iover ithis iKPI, iyou imay iset ia itarget ilength iof istay i(accordingly ito ithe itype iof istay iand iprocedure) ithat iyou iwould ilike ito iachieve.

2. TREATMENT iCOSTS

Calculate ihow imuch ia ipatient icosts ito iyour ifacility

This itypical ihealthcare iKPI iexample ifor imonetary imanagement. iTreatment iCosts iare iimportant imetrics ito itrack ias ithey idirectly iimpact iyour ifinances, ithe icontribution imargin iyou imake iand ithe icapacity iof iyour ifacility ito isustain iit. iThe ipurpose iis inot ito ireduce iit ias imuch ias ipossible ito imake iprofit, ibut ito ispot iabnormal ior iexaggerated iexpenses iand iaddress ithem. iYou ican ibreak iit idown iinto ivarious icategories i-per iunits, iper ioperations, ior ias iin iour iexample, iper iage igroups. iBy iacknowledging ithese icosts, iyou ican ialso ibudget ibetter iand iallow ithe iright iamount iof imoney ito igo ito ithe iright icategory: i25-year-old ipatients icost ion iaverage iless ithan i72-year-old ipatients.

Performance iIndicators

Calculate ithe iTreatment iCosts iaccording ito idifferent icategories iover itime iand ianalyze ithe ievolution.

3. HOSPITAL iREADMISSION iRATES

How imany ipatients icoming iback iafter idischarge?

A itypical ihealthcare iKPI iexample ihere. iThe iHospital iReadmission iRate iprovides iinformation ion ithe inumber iof ipatients ithat ireturn ito ithe ihospital iwithin ia ishort iperiod iof itime iafter ibeing ireleased. iIt iis ione iof ithe imost iimportant ihealthcare imetrics ias iit iprovides ia igreat iinsight ion ithe iquality iof icare iadministered iin ithe ifacility iconcerned i— ibut icannot ibe iused ias ia istand-alone iquality iindicator. iReadmission irates ican ialso ished ithe ilight ion iother iflaws ithe ihospital imanagement iis isubjected ito i(lack iof istaff ior iappropriate imaterial, ioverloaded istaff ineglecting idetails, iunits iwith ispecial ineed i…), iand imay ihelp iin ia ibetter icost icontrol ias iit iaims ito idecrease iexpensive iand iunnecessary ireadmissions.

Performance iIndicators

The ilowest iyour ireadmission irate iis, ithe ibetter. iHigh irates ipoint iout idysfunctional ities ithat imust ibe iaddressed ias isoon ias ipossible.

4. PATIENT iWAIT iTIME

Increase iyour ipatient isatisfaction iscore iby idecreasing itheir iwaiting itime

Patient iWait iTime iis ione iof ithe imost iimportant iaspects iof ipatient icontentment. iIt imeasures ithe itime iit itakes ifor ianyone ivisiting iyour ihospital ifrom iwhen ithey iregister ito iwhen ithey isee ia idoctor iand iget ia itreatment. iIt ican ibe iparticularly iinteresting ito imeasure iit iin iER i(Emergency iRooms) ito ievaluate ihow iprompt ithe ihospital ito ideliver iurgent iservices ito iits ipatients iis. iThis ihealthcare imetric iis ihighly ilinked ito ithe ipatient isatisfaction iscore, ias ino ione ireally ienjoys istaying ihours iin ia ihospital. iIt ican ialso ireveal isome iother iproblems iyour ifacility iis ifacing, iif ithe ifigure iis itoo ihigh, iand ithat ineed ito ibe iaddressed.

Performance iIndicators

The ilower ithe iwait itime iis ithe ibetter. iMeasuring ithis itype iof ihealthcare iKPI iover itime iis ialso iimportant iso ias ito iidentify itrends iand irush ihours ion ia ilonger itime iperiod, iand ieventually iadjust istaffing ineeds ifor ia imore iefficient ipatient imanagement.

5. PATIENT iSATISFACTION

The ishowcase iof iyour ihealthcare ifacility

This iis ianother igreat ihealthcare iKPI iexample ithat ishould ibe ia itop ipriority ifor iany ihealthcare iorganization, iin iorder ito ihave ifeedback iand iimprove ithe iservice. iYou ican iask iyour ipatients ihow ithey ifelt iwhile ibeing itaken icare iof, ihow ithey iwould irate itheir imeals ior ithe itime itaken iby idoctors iand inurses ito iexplain ithem itheir isituation. iSuch iassessment iwill iprovide iyou iinsights ion ithe ioverall iperception iof iyour ihospital iservices iand ishow iyou iwhich ipoints ican ibe iimproved. iBesides, iyour ipatients iwill ifeel ilistened ito ias itheir iopinion iand ifeelings iare itaken iinto iaccount, iwhich iis ianother iimportant icomponent iof ithe isatisfaction iscore.

Performance iIndicators

The ioverall iPatient iSatisfaction iis iprecisely ithe ihealthcare iKPI ithat iwill iattract ior ion ithe icontrary iscare iaway ifuture ipatients. iThe ihigher iit igrows, ithe ibetter iit iis ifor iyour ihospital.

i i i i i i i i i i i i i i i i i i i i i i i i i iPatient isatisfaction iis iclosely ilinked ito ia ihospital’s ilevel iof iorganization iand iefficiency. iIf ipatient irates ihis/her iexperience ias i“dissatisfactory,” ichances iare ihe/she iexperienced ian iunappetizing imeal, ia ilong iwait itime, ior iimpatient istaff imembers. iWhile imediocre ifood ior ia igrumpy ibedside imanner imay inot ibe ias iimportant ias ipreventing ia imedication ierror, ivirtually iany ifactor ior iexperience ithan iturns ia ipatient iinto ia idissatisfied icustomer ipoints iat ithe isame ipotential iproblems:

1. Disorganization

2. Inefficiency

3. Understaffing

Unfortunately, iproblems ilike iunderstaffing iand idisorganization iare iall itoo icommon iin ihospitals. iLast iyear, iScientific iAmerican ipublished ia istory ithat ibrought isome iof ithese iissues ito ilight. iSpecifically istating ithat iunderstaffed ihospitals iwere imore ilikely ito iexperience iproblems iwith iquality icontrol.

For ibusinesses, iit’s ieasy ito isee iwhy icustomer isatisfaction iis iimperative. iHappy icustomers ibecome irecurring icustomers; ihappy icustomers italk ito itheir ifriends; ihappy icustomers iare ithe ilifeblood iof ithe ibusiness.

6. PATIENT iSAFETY

Identify ithe iincidents ihappening iin iyour ifacility iand ireduce ithe ipatients’ iexposure ito ifurther irisk

The iPatient iSafety imeasures ithe icapacity iof ia ihospital ito ideliver iquality icare ito iits ipatients iand ikeeping ithem isafe ifrom icontracting ia inew iinfection, ipost-operation icomplications, ior iany ikind iof isepsis. iThis iis iextremely iimportant ito itrack ithis imetric iassiduously ito iknow iwhere iproblems ioccur, iwhich istage iof ithe iprocess ican ibe iimproved iand iidentify iany iinfection iabnormally ipresent iin iyour ihospital. iYou ican imeasure ithis imetric iand ibreak iit idown iinto idistinct icategories i(post-operation iinfections, irespiratory iinfections, ior itreatment-related idiseases), ito ihave ian ieven imore iaccurate iview iof iyour ihospital iperformance iin ithe imatter.

Performance iIndicators

This ihealthcare iKPI iprovides idata ion ithe iquality iof icare iyour ihospital idelivers ito iits ipatients. iIt iwill igive iyou iinsights ion iwhat imust ibe iimproved iin ithe idifferent iservices.

7. EMERGENCY iROOM i(ER) iWAIT iTIME

Evaluate ithe itime ipatients ispend ifrom ichecking iin ithe iER ito iseeing ia idoctor

ER ior iEmergency iRoom iWait iTime imeasures ithe iamount iof itime ibetween ithe iarrival iof ia ipatient iin ithe iER iand ithe imoment ihe ior ishe ican isee ia iphysician. iThis inumber iis ilinked ito ithe iaverage ipatient iwait itime, ibut iis imore ispecific ias iit ifocuses ion ithe iEmergency iRoom ionly. iEvaluate ithis iKPI iso ias ito iknow iwhen ithe irush ihours iof ithe iday iare iand ithe ibusiest idays iof ithe iweek, ihow ilong iare iyour ipatients icurrently iwaiting iand iset ia itarget iaccordingly. iJust ilike ifor ithe iPatient iWait iTime, iit imay ispark ilight ion iissues i(staff ioverloaded, icheck-in iprocesses ineeding ichange, iER ifacilities icongested) ithe iservice iis ifacing iand ithat ican ibecome ivery iproblematic iif inot isolved.

Performance iIndicators

After iassessment iof ithe iER iWait iTime ion iaverage, iyou ishould ikeep ian ieye ion ithe ievolution iof i