Healthcare organizations are drowning in data. Patient data pours in from the electronic health record (EHR), PACS, VNA, electronic claims systems, document management systems, laboratory systems, enterprise resource planning (ERP) systems and spreadsheets.
In a 2014 survey of healthcare executives, 39% of respondents reported using 11 – 50 platforms or interfaces to extract data and 33% said they are using more than 51.
Data flowing in from so many systems makes it difficult for an organization’s leadership to get a unified view of the information required to make important business decisions. An Integrated Healthcare Services organization, like most organizations, was struggling to give personnel at several levels within the hospital, from nurses on the floor to the executive leaders, more insight into organizational data.
“Altogether we were looking at 25 disparate systems from individual vendors, each with its own reporting mechanism for analytics. We wanted to integrate them all and provide staff with a kind of one-stop shop for analyzing important data,” said the Director, Data Solutions at this Integrated Healthcare Services organization. This situation was exacerbated by mergers and acquisitions as other hospitals joined the organization and brought their own systems into the mix.
At the enterprise level, leaders received reports from multiple departments and in various formats, from spreadsheets to emails with PDF attachments. “It’s amazing to think about it now,” says the Director, “but we were still using a lot of spreadsheets.”
This made for a cumbersome process for leaders, who would review up to 26 different sources of data on a daily basis and attempt to derive insight regarding the overall state of the organization. To complicate matters executives might see two or three different numbers for the same base metric, which made accurate analysis challenging.
Nurses need data to make proactive decisions
At the other end of the spectrum, staff at the operational level, including nurses, medical technicians, and providers, also needed better insight into the effectiveness of their processes and practices.
The charge nurse, for example, had traditionally received a monthly report that included quality metrics, along with patient care and safety metrics. As the frontline manager overseeing a unit within the hospital on any given shift, a charge nurse supervises nurses and takes responsibility for the care of all patients within that unit. Receiving feedback on a monthly basis may assist charge nurses with future planning and improvements, but the leadership team wanted data delivered to them on a daily basis to help them drive performance and make changes to patient care in the present moment. To enable faster insight and action, this data would need to be presented in a dashboard format, rather than the manual chart review process the charge nurses had been using.
Using dashboards for insight into patient care
Needless to say, it was not always easy—or possible—to capture, integrate, analyze and present required data to the people who need it. The answer for this leading integrated services organization was a process intelligence solution.
Since the goal was ultimate to improve patient outcomes, the implementation strategy involved connecting data from disparate systems to offer nurses, managers, and leaders real-time information about patient needs. To support that goal, the team developed a series of dashboards based on the principle of monitoring, measuring and managing. These include, among others:
- The Charge Nurse Dashboard is an operational-level dashboard that enables supervising nurses to monitor patient care as it’s happening. This dashboard provides quality and safety measurements and analysis of patient flow. It provides real-time data to enable the charge nurse to monitor and respond proactively to patient needs and increase the quality of patient care.
- The Nurse Quality Scorecard Dashboard is a management-level dashboard that is focused on nursing education and nursing performance. This dashboard aggregates nursing care data over a large volume of patients with 13-month trending analysis on 10 patient quality and safety measures. It offers an objective view of the patient population and enables a manager to identify opportunities for improvement at the nurse, department, campus and enterprise levels.
- The Enterprise Integrated Dashboard provides executives with insight into the overall health of the organization. This dashboard addresses imperatives that executive leadership has identified, including quality of patient care, preemptively managing risk, driving continuously higher performance and ensuring accountability through the system. It integrates disparate clinical, financial and operational data; provides “always on” KPIs; enables insights into levels, trends and impacts; and replaces manual reporting processes with automated updates.
With process intelligence, nurses, nurse supervisors, ICU staff, lab technicians, executives and others gain information about the effectiveness of processes that impact patient wellness. They can quickly drill down for more detail, and they can discover and address critical issues that left unchecked could lead to problems. “Our process intelligence tool integrates various statistical analysis programs into a dashboard display, but it’s much more than just a dashboard solution,” says the Director. “It’s an analytical tool that gives everyone from nurses to executives continuous insight into patient care. It allows them to see what is actually happening, rather than what they think is happening.”
Real-time data means faster care
Ultimately the most important measure of success for the organization is patient care. For example, the Charge Nurse Dashboard gives nursing staff insight into analytics they didn’t have before, such as immediate visibility into where staffing help is most needed. If one unit’s acuity level is very high, the charge nurse can bring other nursing staff in. If it’s low on another day, the charge nurse can try to support another nursing unit that could use the help.
“We’re trying to get patients the right level of care as fast as possible,” the Director says, and real-time data analysis such as staffing levels and acuity levels offers staff the kind of insight they need to improve patient care. “When I think about that kind of impact,” he says, “it makes me extremely proud of what we’ve been able to accomplish.”
Enabling analysts to gain immediate insight
One outcome of deploying process intelligence has been an immediate time savings for business analysts within the organization. Before the Leadership Dashboard was built, analysts manually produced the daily reports for executive management. This activity alone required nearly three FTEs transposing information into spreadsheets from various source reports. In 30 days they were able to automate this process and add in features that gave executives the ability to drill down for more information or insight.
An unexpected result was how quickly analysts took to the new system and began building their own reports, aggregating and transforming data. “They had been struggling for so long,” recalls the Director. “They were always waiting for IT resources and just trying to get data out of their own systems.” Suddenly analysts were providing new solutions to their business counterparts.
And because analysts were no longer spending time producing manual reports, they were able to do the job for which they were hired: analysis. This has led to new insights in areas such as length of hospital stays and patient safety. Moreover, insights can be immediate, rather than 30 days after the fact. “With monthly reporting,” says the Director, “you find the problem, you come up with a solution. Then it’s three months later before you actually see a benefit. Real-time reporting and analysis have allowed us to be far more agile and proactive.”