dreyer medical clinic
TRANSCRIPT
2006 Best Practices in 2006 Best Practices in Diabetes Care Diabetes Care Sponsored by AMGA and sanofi-aventis U.S., Inc.Sponsored by AMGA and sanofi-aventis U.S., Inc.
April 5, 2007 – Wrap - UpApril 5, 2007 – Wrap - Up
Novel Interdisciplinary Approach to Diabetes Health Management: Translating Clinical Outcomes into Financial and Operational
Success
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A Brief Project OverviewA Brief Project Overview
Are clinical measures enough? Use “Balanced Scorecard Approach1” to
build metrics that are reported at every level of the organization on– Customer Perception (internal / external)– Core Purpose Performance – Continual Innovation and Growth
– Financial Success
1. Kaplan R., Norton D. Translating Strategy Into Action – The Balanced Scorecard. HBS Press. 1996.
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Modifications/EnhancementsModifications/Enhancements
System implemented “Key Results Areas” Needed to shift BSC measures to reflect
organizational KRAs
BSC Term KRA - Equivalent
Customer Perspective 1. Patient Satisfaction
2. Associate Satisfaction
3. Physician Relations
Internal Business Perspective Clinical Outcomes
Financial Perspective Funding Our Future
Innovation and Growth Growth
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Measuring Intermediate SuccessMeasuring Intermediate Success
KRA MeasureGoal /
Stretch Tracking Method
Clinical Outcomes (Internal Businesses
Perspective
• % A1C < 7• % At goal BP
• 50% / 55%• 40% / 60%
• Monthly EMR reports • Monthly EMR reports
Funding Our Future (Financial Perspective)
• Weekly % capacity used
• 55% / 65% • POS Run Chart
Growth (Innovation and Learning)
• New patients - auto referral pts
• 3 / 5 per week • POS Run Chart
Patient Satisfaction (Customer Perspective)
• POS Survey• % of pts w/ out follow-up
• 72% / 77%• 25% / 20%
• Clinic Reports• Quarterly Report
Associate Satisfaction (Customer Perspective)
• % VG internal student survey
•72% / 77% • Survey Run Chart
Physician Relations (Customer Perspective)
• New patients - MD referrals
• 6 / 9 per week • POS Run Chart
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Control BoardControl Board
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Long Term Clinical OutcomesLong Term Clinical Outcomes
Average A1c of patients entering the program is 8.6
48% of patients with an A1c <7 would have continued indefinitely
We are short of our goal of 50%On Monday, we are writing a 90 day
action plan to get us above 50%SMART plans
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Physician Relations / GrowthPhysician Relations / Growth
New MD Referrals / New Auto Referral Patients Pre / Post Auto Referral Process Initiation and Increased Physician Visibility
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4
6
8
10
12
14
16
18
Week
# N
ew P
atie
nts
New MD Referrals Mean
Upper SD Lower SD
Auto Referral Count
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Funding our futureFunding our future
% Capacity Used
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Week
Per
cen
t Cap
acity
Use
d
% Capacity Used Average SD SD
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Challenges?Challenges?
It’s not easy to be balancedBalancing responsibilities (TIME)
– Patients / Clinic / MWU / StudentsProcess of shifting to new “terminology”
– KRA’sData collection – most of our data is
now collected at POS Concept of 90 day action plans
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Future StepsFuture Steps
• Develop “90 Day Action Plans” for each of the KRA’s
• SMART – Goals and Plans
• Specific: What I am going to do • Measurable: We can see it; observable • Aimed: a step toward larger goal • Realistic: I can / will do this • Timeframes: I will have it in place by
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Lessons LearnedLessons Learned
Not all data needs to be generated via a report -control boards work great – Keeps staff aware of progress / generates interest
and excitement
Perspective is important (administration / clinicians) – We have learned from each other – Sometimes things don’t always seem as they appear
(i.e. telephone follow-up not calculated in % Capacity)
Focusing on one area may not necessarily improve others – Focus on increasing new patients without increase in
% Capacity Used
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Questions for the GroupQuestions for the Group
How are you – dealing with unused capacity in your
programs?– encouraging physician referrals to
your programs?– recruiting new patients to your
programs?– assessing patient satisfaction?
• Do you have tool you are using?• Response rates?