Benchmarking and performance indicators
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Benchmarking and Performance Indicators. Overview. Jay Ford, PhD. Agenda. Framework for benchmarking Role of benchmarking Example benchmark measures Importance of comparative feedback Process Steps Review of a current benchmarking initiative. Some is not a number, soon is not a time.

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Agenda l.jpg
Agenda

  • Framework for benchmarking

  • Role of benchmarking

  • Example benchmark measures

  • Importance of comparative feedback

  • Process Steps

  • Review of a current benchmarking initiative



Key definitions l.jpg
Key Definitions

  • Gift and Mosel (1994) define benchmarking as “the continual and collaborative discipline of measuring and comparing the results of key work processes”

  • A performance or key performance indicator (KPI) is a measure of performance.

  • Performance measurement is the process used by an organization to establish the parameters to measure if programs are reaching the desired results


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Who uses data?

  • Decision Makers

    • State (e.g., SSA or Legislature)

    • Funding Agency(e.g., State or Managed Care)

    • Provider (e.g., Executive Director, Board)

  • Consumers

    • Clients

    • Employers

    • Employees


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Data is important to the ….

  • … state because they need to show that treatment is working

  • … legislative body because they want to be sure that citizens are receiving a quality services for their investment

  • … managed care companies who are interested in quality care


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Data is important to the ….

  • … consumers who need to get into treatment now and want to receive quality care

  • … employees who need to understand that their efforts are beneficial to the agency and clients

  • … employers seeking quality care for their employees


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Data is important to the ….

  • … executive director who needs to effectively and efficiently run the treatment agencies


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Alignment

Outside Influences

Inside Influences

Consumer

Accreditation

NOMS

Board

Payer (State or Managed Care

Employers

Management

Employees


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The challenge is to bring it all together to create a cohesive picture within your organization


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Performance is measured in all settings cohesive picture within your organization

How helpful is performance data?

Does data drive organizational vision?

Does data drive organizational decision-making?

The Measurement of Organizational Performance


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The Limitations cohesive picture within your organizationof Outcomes

  • A thermometer reading would be of no value as a measure of your health…

  • If you didn't know that 98.6 is the “average” temperature!


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The Limitations of cohesive picture within your organizationOutcomes in Your Organization

  • Similarly, knowing that your missed appointment rate is 27% is of little value in evaluating the health of your agency…if you don’t know how others are performing


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Data without Meaning cohesive picture within your organization

  • We are deluged with data without meaning

  • Data without a context is just a bunch of numbers

  • What is the answer?


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The Role of Benchmarking cohesive picture within your organization

  • Benchmarks provide the vital internal and external context for understanding your outcomes


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Descriptive Benchmarking cohesive picture within your organization

Comparative Benchmarking

Process Benchmarking

Each builds on the preceding type

A Tiered Model of Benchmarking


Descriptive benchmarking l.jpg

Most common form of benchmarking cohesive picture within your organization

Industry overviews, government reports

Static snapshot of industry performance

No formal or statistical comparisons between an organization’s performance and industry norms

“Eyeball analysis” can be misleading

Descriptive Benchmarking


Example descriptive benchmark l.jpg
Example Descriptive Benchmark cohesive picture within your organization


Example descriptive benchmark report l.jpg
Example Descriptive Benchmark Report cohesive picture within your organization


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Formal comparison of an organization’s performance against a descriptive benchmark

Typically reported as percentile rankings but can be reported in graph form also

Comparative Benchmarking



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Benchmarking differs from formalized research or laboratory science

Benchmarking views data as a vehicle rather than a destination

Benchmarking generates ideas and hypotheses---not answers

Benchmarking is a communal activity

Important Benchmarking Concepts


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Human nature gives benchmarked data its power science

Raw data tells no stories

Benchmarked data draws comparisons

Nobody wants to “bring up the rear”

Benchmarked data prompts action

Benchmarking as an Impetus to Action


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The Limitations scienceof Benchmarking

  • Benchmarks profile your organization against others and help identify opportunities for improvement


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Improve? How? science

  • Benchmarks do not give any indication as to how to improve


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Based on a simple premise: The methods of top performers differ from those of others

Process benchmarking systematically compares tactics of top performers with those of others

Methods that distinguish between top performers and others may be regarded as potential best practices

The “How”: Process Benchmarking


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Surprises Abound differ from those of others

  • What is expected usually does not materialize

  • Top performers do not know why they perform well

  • Subtle factors often prove to be powerful


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All concepts also apply to internal benchmarking differ from those of others

Descriptive, comparative or process benchmarking can be conducted within an organization

Examples of internal comparative benchmarks:

Productivity differences among staff

Access differences among locations

Unit cost differences among programs

Staff satisfaction differences among leaders

Internal Benchmarking


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Looking at the Whole Picture differ from those of others

Clinical

Business


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Types of Benchmark Measures differ from those of others

Time & Attendance

Scheduling

Materials Mgmt

Registration

Billing

Payroll


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Example Benchmark Measures differ from those of others

  • Business

    • Days between 1st contact and assessment

    • Days between assessment and 1st treatment

    • Successful transition across levels of care

  • Clinical

    • Engagement or Retention

    • No-show or cancellation rates

  • Client

    • Satisfaction

    • Family engagement


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Example Benchmark Measures(cont) differ from those of others

  • Financial

    • Cost per unit of service

    • Payer mix

    • Net days in account receivable

    • Days cash on hand

  • Productivity

    • Average caseload size

    • Average group size

    • Staff turnover


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Identify potential best practices through process benchmarking and other vehicles

Enhance organizational performance through NIATx principles

Emphasis on shared learning from one another and from “top performers”

Moving Beyond “the Numbers”


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Comparative Feedback benchmarking and other vehicles

  • Understand the whole picture

  • Select a few key outcome measures

  • Use of reports to guide questions

  • Benchmarks vs. Targets

  • Focus on the comparison (internal vs. external)


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Comparative Feedback benchmarking and other vehicles

  • Measurement Comparisons

    • Performance vs. Outcomes

    • Business Process vs. Treatment Performance/Outcomes Importance of comparisons

  • Types of Feedback Reports

    • Data Quality

    • Performance Reports

    • Pay for Performance


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Comparative Feedback benchmarking and other vehicles

  • Organizational Performance versus

    • a target (internal) or

    • a benchmark (external)

  • Types of comparisons

    • Internal comparisons over time

    • External performance comparisons to other similar organizations

    • External performance comparisons to other agencies within a state


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Two Quick Examples benchmarking and other vehicles

  • Dashboard Reports

  • Oklahoma Department of Mental Health and Substance Abuse Services


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Benefits of a Dashboard benchmarking and other vehicles

  • Set realistic objectives and create buy-in

  • Use of data maintains quality

  • Support from outside the organization

  • Help build referrals and funding

  • Requires human interpretation


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Steps of Developing a Benchmarking System benchmarking and other vehicles


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SAAS, NIATx, and Behavioral Pathway Systems are partnering to sponsor an addiction-specific national benchmarking initiative

BPS specializes in behavioral health and human services benchmarking and has numerous state and national benchmarking initiatives underway

Benchmarking for Organizational Excellence in Addiction Treatment


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Current Benchmark Domains to sponsor an addiction-specific national benchmarking initiative

  • Operational Benchmarks

  • Clinical Benchmarks

  • Organizational Climate

  • Financial Benchmarks


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Resources to sponsor an addiction-specific national benchmarking initiative

  • Gift, R. and Mosel, D. (1994). Benchmarking in Health C are, American Hospital Association

  • Migas N (2010) Let dashboards lead you to success. Behavioral Healthcare. February 2010, 12-15

  • Knopf, A (2010) Magellan, Maricopa pass contract midpoint. Behavioral Healthcare. February 2010, 16-19

  • Lefkovitz PM, Ford J, Vaughn B and Nance R (2009). Promoting benchmarking in addiction treatment. Behavioral Healthcare. 29(4): 28-30.


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