Building custom indicators to measure performance against hospitals nationwide

What drove the need for your hospital to create this financial dashboard?

The need really came from the change in our hospital status. We went from a PPS hospital to a Critical Access Hospital in July of 2016. When that happened, our board members were asking us how healthy we are in comparison to other Critical Access Hospitals. They asked me and a few others from our executive team to look for some guidelines to benchmark our performance. They wanted to see these reports at our board meetings to ensure that our hospital was staying on track.

How did you select what you were going to track?  

We actually found a recent study on Critical Access Hospitals which included numerous indicators. We looked through those indicators and together selected 10 indicators we felt were important to track. We presented our selections to the board, got their approval and then we were off to the races.

Can you tell us what types of indicators these included?

Some of things we wanted to monitor included changes in revenue, changes in our operating margin, and changes in utilization. We also need to carefully watch our bad debt and charity. And we set specific departmental goals to monitor and improve.

So how did you go about getting these indicators set up?

Well, before we received the Critical Access Hospital designation, I used to have run a few reports for our board, but it was a very manual process. Since our board was asking for regular recurring updates on these 10 indicators, I knew I would not be able to keep up with that process manually. We had been using the Medisolv software Rapid for many years. I spoke with Jorge about setting up these custom financial indicators on a dashboard for us.

What did that process look like?

For each indicator I had to think through what the formula would be manually. I would communicate that formula to Jorge. Jorge would then build the indicator based on that calculation. He’d send it back to me to review and if it didn’t look right, I went through the process of figuring out why it didn’t work out properly. I’d send the corrections back to Jorge. He’d update it and I’d look at it again. That’s how the process went for all of the indicators until every one of them was producing accurate results. It took about four to six months to complete the entire process.

How do you use those indicators now?

Well at first, we used them frequently to present to the board. After a while, the board was satisfied that our hospital was looking very good against the nationwide benchmarks. Now we use these indicators ad hoc when we need them. Sometimes the CEO or COO will have a question on performance or utilization for the hospital as a whole or about an individual department and I’ll just quickly pull the report and shoot it over to them.

We also use the reports on the bulletin boards we have around the hospital. I’ll work with our other departments to decide what is important and we’ll post refreshed data for our teams to see.

It’s a great way for us to quickly and easily validate when something is moving in either an up or down way. So, let’s say an event occurs at our hospital, we can see that ramification reflected in our numbers on this dashboard.

Why is this important to an organization such as yours?

As a Critical Access Hospital, there are a lot of moving pieces which affect our operating margin. A provider moving in or out of town can significantly change our utilization which can impact our margin. It’s important that we be good stewards of our resources. We want to ensure we use our funds to get better tech, better staff and better resources to educate our staff. In this way, we are creating something that’s a reinvestment into our community.

As we constantly monitor our financial indicators, we are quickly aware of any changes that could make a difference to our margins. Our community relies on us to be here. We take that responsibility very seriously.

Anything else before we go?

I would just like to say that it was a really good experience working with Jorge. He is a very productive person. At a Critical Access Hospital, we are always so busy, and I really needed someone to keep me on track that I could rely on. Jorge was great at doing that. He would keep the project moving along and I would always thank him for keeping me on track.