Performance Improvement Dashboards and Benchmarking presented by Shelley D. Voelz, RN,BSN, CPHQ, FNAHQ Director Standards Compliance and Patient Safety for the Indiana Chapter of International Executive Housekeeping Association April 9, 2010. Learning Objectives.
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Performance Improvement Dashboardsand Benchmarking presented byShelley D. Voelz, RN,BSN, CPHQ, FNAHQDirector Standards Compliance and Patient Safetyfor theIndiana Chapter of International Executive Housekeeping Association April 9, 2010
Health care executives use performance dashboards to keep tabs on enterprise health based on the concept of an automobile dashboard. Performance dashboards seek to distill reams of performance data into a few key metrics, giving executives user-friendly “snapshots” of a department or organization’s overall performance.
Delays and difficulties in understanding performance is problematic in that in our current health care environment industry margins have fallen resulting in little room for error, even small divergences from financial projections can plunge you into the red.
Creating a dashboard is the first step in ensuring that mounting performance problems are addressed quickly. Dashboards speed up problem recognition but do not force remedial action.
Many in-house housekeeping operations are mandated by CEOs to provide a dictated service level. The key point is that a housekeeping manager seldom has the authority to significantly change the service level, along with the corresponding budget and resulting benchmarks, without prior approval from somewhere up the chain of command. However, when the service level is adjusted, so is the labor. The higher the service level, the higher the labor used. Labor represents roughly 90 percent of some housekeeping budgets.
The goal should be to modify the service level without impacting the hospital's appearance in a noticeable way. In general, the following two rules of thumb can be used to accomplish this:
Creating an exceptional environment of care around your patients will guarantee their safety, comfort, and confidence in their clinical care. Our customer-focused healthcare environmental services start with our employees who deliver consistent levels of performance that yield high patient satisfaction scores. In addition, each manager is trained in our patented hospital housekeeping techniques to improve HCAHPS performance.
1. Metric Balance: Use financial and operations indicators with
2. Metric Austerity: Performance is distilled to 15 to 30 metrics with little redundancy.
3. Graphic Display: Trends and data interrelations graphed to allow better, more rapid pattern recognition.
4. Action Triggers: Specific targets or threshold, below which immediate action must be taken. These targets are derived from past performance and industry benchmarks.
Four elements of an effective dashboard are:
1. Financial Data
2. Clinical Quality Data
3. Operational Data
4. Satisfaction Data
Financial: This area indicates the organization’s overall profitability, cash flow and ability to meet budget expectations.
Operations: Measures for productivity and how well cost containment is working as
well as growing the business.
Quality: This area illustrates how well the organization is providing its product – patient care which impacts how the organization grows revenue. Measures of clinical quality and service quality should be included.
Satisfaction: Measures in this area include patient, physician and employee loyalty and satisfaction.
Variance from Budget
Actual FTEs Compared to Budgeted
Productive vs. Non-Productive Hours
Hours Worked per Adjusted
Nosocomial Infection Rate
Findings from Room Inspections
Square Footage Cleaned
Discharge Bed Cleaning
Lost Work Days due to Injury
Environmental Services Labor Expense
per 100 adjusted discharges
Hours Worked per 1,000 Net Square
Labor Expense per 1,000 Net Square Feet
Patient Complaint Rate
Employee Satisfaction Survey
Physician Satisfaction Survey
1. Initiate Project
2. Solicit Ideas
3. Gather Data
4. Establish Prototype
5. Solicit Feedback
6. Revise Prototype
7. Present to Users
8. Implement Dashboard
Attaining consistently high levels of cleanliness, decreasing your HAI rate, and continuously improving quality will naturally result in improved regulatory compliance.
Benchmarking is the practice of being humbleenough to admit that someone else is better atsomething and wise enough to learn how tomatch and even surpass them at it.Carla O’Dell, Continuous Journey, April 1994
A definition that best fits the intent of the long term goals and objectives of a benchmarking
effort defines it as “the process of identifying, understanding, and adopting outstanding practices and processes from organizations from anywhere in the world to help your organization improve its performance.”
Benching is a process of measuring another organization’s product or service according to specified standards in order to compare it with and improve one’s own product or service. Internal benchmarking occurs within the same organization. External benchmarking occurs outside of the organization with another organization that produces the same product or provides the same service. Functional benchmarking refers to benchmarking a similar function or process such as scheduling in another industry.
similar functions at different industries.
More recently, benchmarking techniques have been used in service-oriented companies to the same end. Rightly or wrongly, hospital administrators base many decisions on these data. Thus, knowing how facility housekeeping benchmarks are developed and what can be done to improve them may effect how a facility's environmental services department will be perceived by the hospital's administrator.
Before a manager attempts to improve his or her benchmark numbers, he or she must first understand how the facility reports its own information, which eventually results in department benchmark numbers. In the case of "cost per square feet," understanding the definition of both "cost" and of "square feet" can help a manager make his or her benchmark numbers look better from the outset.