how to adapt your organization to the future: a guide to
TRANSCRIPT
www.openminds.com n 15 Lincoln Square, Gettysburg, Pennsylvania 17325 n 717-334-1329 n [email protected]
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.
© 2018 OPEN MINDS
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
© 2018 OPEN MINDS
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
© 2018 OPEN MINDS
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
© 2018 OPEN MINDS
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
© 2018 OPEN MINDS
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
© 2018 OPEN MINDS
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
© 2018 OPEN MINDS
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)
© 2018 OPEN MINDS
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
18
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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