how to adapt your organization to the future: a guide to

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How To Adapt Your Organization To The Future: A Guide To Managing Data For A Performance-Driven

Environment

T h e 2 0 1 8 O P E N M I N D S M a n a g e m e n t B e s t P r a c t i c e s I n s t i t u t e T h u r s d a y , A u g u s t 1 6 , 2 0 1 8 | 1 0 : 1 5 a m – 1 1 : 3 0 a m

J o s e p h P . N a u g h t o n - T r a v e r s , E d M , S e n i o r A s s o c i a t e , O P E N M I N D S

© 2018 OPEN MINDS

AgendaI. Leveraging Metrics-Based Management To Improve Organizational

Performance

II. Common Tools For Your Performance Management System

III. Staff Information Literacy: The Key To Leveraging Data To Improve

Performance

IV. Case Study: Kings View Corporation

V. Questions & Discussion

2

© 2018 OPEN MINDS© 2018 OPEN MINDS

I. Leveraging Metrics-Based Management

To Improve Organizational Performance

3

© 2018 OPEN MINDS

Metrics-based management is the

path from information to action.

A longer definition – a model of

managing processes, outcomes, and

performance that relies on qualitative

and quantitative measurement of the

current performance, the desired

performance, and the objectives and

action plans to improve performance.

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A Framework For Performance Management

Determine critical performance outcomes for success of organizational strategy (starts

with the strategic plan)

Distill from these performance outcomes the specific measures (leading and lagging)

that would best enable the management or measurement of success

Determine which of the data to create these measures are available in current data

systems – and identify proxy data and measures where not available

Design dashboard based on available measures

For each measure, create an appropriate display and measurement and reporting

specifications

For long-term planning, identify data not currently available in system for necessary

measures and conduct ROI of costs to gather data

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Key Steps For Implementing Performance Management

Identify and quantify what ‘performance’ means for your

organization

Create an overarching organizational strategic dashboard for the board and executive team

based on strategic vision, mission, and objectives

Develop an executive team dashboard of leading indicators of

organizational success

Design a dashboard at the business unit/program level that provides

managers with the tools to measure and maximize unit performance

Leverage Operational Performance Within Programs With Functional

Dashboards

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Pushing Data To Managers Is Key To Leverage – Dashboard Is Common Model

An intuitive graphical display that is thoughtfully laid-out and easy to navigate

A logical structure that makes information easily accessible

Little or no user training is required

Data displays that can be customized and categorized to meet the specific needs of

each user.

Regular and frequent updates of dashboard information for accuracy and relevance to

current conditions

Information from multiple sources, departments, or markets can be viewed

simultaneously

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Common Tools For Your Performance Management System

Critical management reporting

A “Balanced Scorecard” approach to metrics selection & dashboard development

Bench-marking metrics

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Critical Management Reports

These ensure that all staff has access to the accurate, up-to-date information that they

need to do their jobs on a daily basis

With roughly 90% of the reporting needs for organizations being planned and

predictable, this simply means producing and using meaningful reports from the

management information system and making certain that staff know how to use them

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Access To Care & Revenue Reporting

#1 Access To Care Reports

# of referrals / % accepted for admission

# of admission denials by reason

Waitlist information

Time metrics for access to care

#2 Revenue / Productivity Reports

Census to budget

Unit-fee productivity reports

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A/R & Other Financial Reporting

#3 Financial Reports

Averages days in A/R

Collection %

Bad debt percentage, dollars, by reason

Late charges

Income statement, budget to actual

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Outcome & Compliance Reporting

#4 Outcome & Satisfaction Reports

Outcomes

Successful discharges

#5 Compliance Reports

Records compliance

Critical incidents

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A Balanced Scorecard Approach for Metrics Selection

Based on the 1992 article, “The Balanced Scorecard

- Measures that Drive Performance," (Harvard

Business Review) by Kaplan & Norton

Kaplan and David P. Norton included anonymous

details of the use of Balanced Scorecard in this

article

In 1996, they published the book The Balanced

Scorecard: Translating Strategy into Action (Harvard

Business School Press)

Due to these works, Kaplan & Norton are often seen

as the creators of the Balanced Scorecard concept

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History Of The Balanced Scorecard Concept

The roots of the balanced

scorecard concept include:

The work of General Electric on

performance measurement reporting

in the 1950s

The work of French process

engineers (who created the Tableau

de Bord – literally, a "dashboard" of

performance measures) in the early

part of the 20th century

The first Balanced Scorecard was created by Art Schneiderman (an independent consultant on the

management of processes) in 1987 at Analog Devices, a mid-sized semi-conductor company

He participated in an unrelated research study in 1990 led by Dr. Robert S. Kaplan in conjunction

with U.S. management consultancy, Nolan-Norton, and during this study described his work

on the Balanced Scorecard

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The Four Perspectives

The 1st Generation design method proposed by

Kaplan & Norton was based on the use of three

non-financial topic areas as prompts to aid the

identification of non-financial measures in

addition to one financial measure

Based on assumption that focusing on

financials alone is path to failure

Balanced set of KPI reflect four

key management perspectives

1. Financial performance

2. Customer performance

3. Organizational

innovation

4. Internal operations

(clinical and

administrative)

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Benchmarking For Performance Improvement

Using benchmarks and performance targets to challenge and drive continuous

improvement in service quality and operations

Allow your organization

to

• Compare with other firms in your industry

• Develop cross-industry comparisons

• Develop points of reference or standards of practice

• Make best-in-class determinations

• Develop best practices

© 2018 OPEN MINDS

What Is Information Literacy?

Staff knows what data is available, how to get it

and dissect it into valuable operational and

management information, and how to use it

effectively in their day-to-day work

The “high IQ” organizations have

comprehensive plans for gathering, analyzing,

disseminating, and using informationThe

Retrospective Phase

The Directive Phase

The Predictive

Phase

The Phases Of Information Literacy

© 2018 OPEN MINDS© 2018 OPEN MINDS

IV. Kings View Behavioral Health Case Study

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Kings View Behavioral Health

Managing Data For a Performance

Driven Environment

Presentation

• Kings View Organization – Leon Hoover, MSW, M. Mgmt., CEOAnswering the Why question

• Business Intelligence – Jim Rodriguez, MBA, CSBI, CFO

• Health Information Analytics – Anthony Prieto, Director of Health information Analytics

• Quality and Performance Improvement – Alex Rocha, MBA, CPHQBringing it all together

Kings View Organization

• Corporate classification 501(c)(3)

• Created In 1951 To Provide Mental Health Inpatient services, In Reedley California.

• Today, Community Behavioral Health Services• No residential or inpatient services

• Primarily serve consumers funded with public dollars

• Corporate Office in Fresno, California

Kings View Services

• 2017 - Touched The Lives of 36,000 Consumers

• $32,000,000 In Revenue FY 17/18

• $35,000,000 Budgeted Revenue FY 18/19

• Approximately 400 Staff serving agencies in twenty-nine California Counties

• Direct Services Concentrated In The Central San Joaquin Valley

California Behavioral Health Market

• 2017 Census Population of 39,589,144

• 58 Counties – Small and Large!• Alpine 1,156 • Los Angeles 10,231,271

• California Model; County Is The Managed Care Organization (MCO)

California Behavioral Health Market

• Multiple Public Sector Funding Streams• Behavioral Health Services Delivered by a Combination

of County Government and Contracted Private Providers

• Behavioral Health Cost Reimbursed Contracting Structure

• Creates a Complex Strategic and Operational Environment

Service Lines

DUI/PC 1000

Behavioral Health

Intellectually Challenged

Telepsychiatry

Consulting Services EHR and Billing

Information Analytics

Cost Report Services

Youth Empowerment

Value-Based Reimbursement Competency• Organizational Culture

• The New Cultural Competency: Ability to “Turn On A Dime.” Open Minds, Monica E. Oss, 7/25/2018

• 54% of Organizational Change Initiatives Are Successful • Culture Eats Strategy for Breakfast: Attributed to Peter Drucker

• Leadership Is Critical• One Team Culture

• Strategic Goals• Recruitment and Retention• Leadership Development• Financial Strength• Experts In Data Collection, Analysis and Visualization

Business Intelligence

Jim Rodriguez, MBA, CSBIChief Financial Officer

Focus Areas

• Organizational Challenges• Business Intelligence Overview• Kings View’s BI Goals• BI Considerations

Challenges Facing Organizations

Typical Organization’s Concerns

1. Financial Constraints2. Workforce Shortages3. Disconnected Software Solutions4. Regulatory Compliance

Business IntelligenceOverview

What is Business Intelligence (BI)?

1. “BI is a technology-driven process for analyzing data and present actionable information”. (techtarget.com)

2. Collects data from internal systems and external sources

3. Includes resources such as business tools, dashboards, reporting, prediction analysis, and charting, etc.

Sample BI Architecture

ERP

HRIS

EHR

Stand alone systems

DatabaseBI

Applications

End Points

Kings View’sBusiness Intelligence

Goals

BI Broad-based Goals

1. Keep pace with internal and external environmental factors

2. Cutting edge in data analytics for a competitive advantage

3. Provide consistent and standardized reporting

4. Compatibility with other systems

Phase 1 Goals – Financial Focus

1. Successful setup with ERP2. Implementation of allocation

methodologies3. Implementation of Financial Planning

Module4. Design Standardized Financial Reports

Phase 2 Goals – Statistical Focus

1. Importing EHR Operational Units of Service

2. Importing HRIS data3. Creating a Position Control Model4. Creating a Provider performance

Model

Phase 3 Goals – Visualization Focus

1. Dashboards and Scorecardsa) KPI’s and KRI’s

2. Charting and graphing3. Predictive analytics, What-if Scenarios4. Capex Model

Business IntelligenceConsiderations

Organizational Requirements

The Three C’s

1. Cultural adoption from key stakeholders2. Cross-collaboration, e.g. Finance, IT and QI3. Commitment of resources Financial, Time, Personnel

Health Information AnalyticsInteractive Dashboards

Anthony Prieto

Director of Health information Analytics

Focus AreasDashboard Examples

• Clinical Operations• Assessments/Outcomes• Fiscal/Billing• Compliance

Clinical Operations Dashboards

Staff Productivity Dashboard Drilldown

Staff Caseload Penetration

Assessments andOutcomes Dashboards

Outcomes Data(PHQ 9 & GAD 7)

Outcomes Data(PHQ 9 & GAD 7)

Outcomes Data(PHQ 9 & GAD 7)

Fiscal and Billing Dashboards

Claimed by Pay Source

Claimed by Pay Source

(Denials Drilldown)

High Utilizers

ComplianceDashboards

Appointment Type

Appointment Type

ANSA – CANS Outcome Data

Data Extraction and Mapping

Data Input

Data Input

Data Input

Data Input

Data Input Data Input

Data InputData Input

Data Output

Additional Dashboards

Kings View Analytics website:

kvanalytics.com

Quality and Performance Improvement

Alex Rocha, MBA, CPHQDirector of Quality Improvement

The Development and Improvement of Data Driven Key

Performance Indicators

Focus Areas

• Challenges with Developing Key Performance Indicators

• Using data to identify opportunities, change behavior and drive performance

• Organization, Manager and Employee benefits to utilizing performance data

• Considerations for data integrity, validation, and employee engagement.

Challenges Managers and Organizations Face with Developing Key Performance Indicators

Actual Case Study Project: Progress Note Timeliness

• Variation in Mental Health Plan Standards across Counties.

• Data Limitations from the County EHR – Accessing the right information (data extracts) to analyze and identify opportunities.

• Engaging staff to change their behavior and use data analytics in their day-to-day jobs to improve performance.

QI Indicator: Progress Note Timeliness

Why is this important?• Progress Note Timeliness has multiple advantages and will ensure; quality of care

and best practice, contract compliance and retention with County’s, accuracy of progress notes, continuity of care, timely billing of services, and improve client engagement and accountability.

Scope of Work: • Developed Goal/ Aim Statement: Kings View will improve Progress Note

Timeliness of 0-3 days to 80% compliance (set standard) by May 2018. • Meet with Clinical Teams to discuss and understand challenges.• Leverage analytics dashboard to identify areas of improvement and drive

performance.• Review, revise and develop new standards for Progress Note Timeliness that align

with industry standards.

Data Access/Limitations

• Data limitations exist with regard to access, accuracy, and ones ability to trust or understand what the data is telling them to be able to make fact based decision-making.

• Sample Progress Note Timeliness Report from EHR

Utilizing data to identify opportunities, change behavior and drive performance

• Sample Progress Note Timeliness and Productivity Dashboard

• Realtime Data

• Benchmarking

• Drill down capability by location, by staff, and service date timeframe.

Utilizing data to identify opportunities, change behavior and drive performance

• Sample Progress Note Timeliness Dashboard for individual staff

• Using employee performance data benefits employees, managers, and the organization.

Employee and Manager Benefits

Data allows managers to engage employees with their performance in an efficient and effective approach

• For managers, data creates alignment with performance goals.

• For employees, this level of transparency leads to higher employee ownership of their performance.

Considerations for Data Integrity and Validation

• Sample EHR Extract File

• Validation of Service Codes used

• Validate Individual Staff Performance

• Report Run Time Frames and Frequency

Progress Note Timeliness Improvement

Implemented Collaborative

Documentation

Implemented PN Timeliness Dashboard

Closing remarks

• Overcoming these organizational challenges begins with shaping a plan.

• Developing key performance indicators and measuring employee performance is harder than it looks.

• In the right hands with the proper approaches, the potential for data to support decision-making and improved performance is remarkable.

© 2018 OPEN MINDS© 2018 OPEN MINDS

Questions & Discussion

82

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