Oregon Medical Group is using principles from Lean methodology to translate the organization's high-level goals into the daily work of clinicians and staff.
A saying from popular process improvement regimes is that "what gets measured gets done." That's important for senior healthcare executives to remember. But that truth leaves out the critical question of what should be measured.
The options are endless, but determining the most important metrics to measure in an era in which healthcare is transforming is no trivial decision.
The move toward reimbursement based on the value the healthcare organization provides to the patient and the payer, which is happening at vastly different rates in some geographical areas compared to others, means that asking and answering that question at regular intervals is crucial.
If that's the case, what are the metrics that leaders need to watch to ensure clinical, financial, and strategic success?
Pillars of Success
For Oregon Medical Group, a physician-owned multispecialty clinic of 140 providers in Eugene, key metrics fall into five strategic pillars:
- Quality
- Patient experience
- Healthy workforce
- Growth
- Total cost of care
But defining success in those pillars is about more than scores on an annual report card or completing one-off projects, says Karen Weiner, MD, MMM, CPE, the group's CEO.
In the spring of 2016, the group began implementing a daily management system (DMS) that has taken the high-level goals of the organization and translated them into the daily work of clinicians and staff.
Related: Beating Clinician Burnout
The DMS, an element of Lean business methodology, is especially interesting because it allows workers to choose their department's metrics.
For example, while the group tracks CGCAHPS (Clinician and Group Consumer Assessment of Healthcare Providers and Systems) scores to monitor patient satisfaction, the DMS has helped improve results around particular questions related to accessibility by telephone.
"We had low scores in that area, so the clinics decided we'd make a goal of fewer than 5% dropped calls," says Weiner.
The clinics then measure themselves against that goal daily, and report their results as part of an organization-wide huddle every morning that includes the central business office looking on via smartboard.
"Well, we did get more than 5%," Weiner says. But the group noted that the spike occurred between 10 a.m. and 11 a.m., so they shifted staff around so that there were no outbound calls during that hour, freeing everyone up to take inbound calls.
Solving Problems Upfront
"They problem-solve on the front end," she notes. "It's not the administration that has to come in and show them their stats and tell them they've got to fix it. They're right on it, and they celebrate their daily successes."
So far, seven of the group's 14 clinics have adopted the DMS and give a report during the daily huddle. The clinics that haven't been part of the deliberately slow, methodical rollout yet are eager to implement.
"It honestly takes 90 seconds to hear it all," Weiner says. "And the whole organization gets to hear what's happening across all clinics. And if there are problems that need to be kicked up, that's where they're kicked up, and everybody hears about it at the same time. It's changed everything," she says.
Another example of a goal set by Oregon Medical Group clinics is to have support staff all receive a 60-minute lunch break every day, which falls under the pillar of healthy workforce.
"It's a way to put your money where your mouth is and let the staff know this is something we prioritize," Weiner says.
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.