Make Your Own Case
Once the infrastructure for tracking and reporting productivity is in place, hospitalists can use performance metrics to build their own case, remarks Dr. Kealey. The white paper furnishes several examples of customized dashboards. Some use a visual display to illustrate improvement or maintenance in key performance areas.
Dr. Westle notes that metrics reports can be used in a variety of ways, including:
- Negotiating with the hospital;
- Managing a practice internally (i.e., tracking the productivity of established and new full-time equivalent employees (FTEs) and compensating physicians for their productivity); and
- Negotiating with third-party payers who increasingly rely on pay-for-performance measures. For instance, Dr. Westle says, if a group can track its cost per case for the top 15 DRGs and show those costs are less than the national average, this “puts the hospitalist group at a significant advantage when talking to insurance companies about pay for performance.”
Dr. Deitelzweig reports that his HMG at the Ochsner Health Center posts monthly updates of its dashboard results in the halls of its department and others. “Whether it’s readmission rates, patient satisfaction, or hand washing, it’s up there for all to see,” he says. He believes that this type of transparency is not only a good reminder for staff but benefits patients, as well. “It’s helpful because it highlights for your department members the goals of the department and that those are aligned with patient satisfaction and best outcomes.”
“If hospitalists can work with their hospitals to understand how various data elements are defined, collected and reported,” says Flores, “this will enable them to develop a greater understanding of what the information means, correct any misinterpretations on the hospital’s part, and gain a greater confidence in the information’s credibility and reliability. Hospitalists should work closely with their sponsoring organizations to define metrics and reports that are mutually credible and meaningful, so that all parties are looking at the same things and understanding them the same way.”
Participating in the white paper project gave Dr. Rauch a better appreciation of the value of measuring performance. His advice to first-timers: “It may seem overwhelming at first to do an all-encompassing dashboard, but even if you pick just a couple things to start with, this puts down on paper what your worth is. When you can point to how your services are improving or maintaining over time, that’s the picture that says a thousand words.” TH
Gretchen Henkel is a frequent contributor to The Hospitalist.