Here is our September 2019 meeting presentation to the Chicago Technology For Value-Based Healthcare Group (https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/) on meaningful KPIs in the hospital setting.

1. Richard Clancy, MSPH
September 24, 2019

2. Disclaimer: All Scorecard Slides Do Not Present
Actual Data and Do Not Represent Any Actual
Organization

3.  Value Based Care Measures
 Scorecard vs Dashboard
 Scorecard Examples
 Public Scorecards
 Unintended Consequences

4.  The Hospital Value Based Purchasing (VBP)
reduces the (FY) 2019 MS DRG payments by
2%, estimate available is $1.9 billion
 Redistributes the sum total amount of this
reduction to hospitals based on their Total
Performance Score

5.  Clinical Domain
 Person and Community Engagement Domain
 Safety Domain
 Efficiency and Cost Reduction Domain

6. Clinical Domain
 AMI 30 Day Mortality
 HF 30 Day Mortality
 PN 30 Day Mortality
 Complication rate following total hip/knee
arthroplasty
Person and Community Engagement
Domain
 Communication with Nurses
 Communication with Doctors
 Responsiveness to Hospital Staff
 Cleanliness and quietness of Hospital Environment

7. Safety Domain
 Central line-associated bloodstream infection
(CLABSI)
 Catheter-associated urinary tract infection (CAUTI)
 Surgical site infection (SSI)
 Methicillin-resistant Staphlococcus Aureus (MRSA)
 Clostridum difficile Infection (CDI)
 Perinatal Care (PC-01) delivery scheduled 1-2 weeks
early when not medically necessary
Efficiency and Cost Reduction Domain
 Medicare spending per beneficiary (MSPB) measure

8. Domain Weight
Clinical Care 25%
Person and Community
Engagement
25%
Safety
25%
Efficiency
25%

9.  Primary Care - Physician
 Finance Key Indicators
 Case Management
 Critical Care
 Through Put
 RRT/Code Blue
 Observation
 Emergency Department

10. “In the long history of humankind
(and animal kind, too) those who
learned to collaborate and
improvise most effectively have
prevailed.”
― Charles Darwin

12.  Ongoing Professional Practice Evaluation (OPPE)
◦ Routine monitoring – a screening tool to evaluate all
practitioners who have been grated privileges and to
identify those clinicians who are delivering good or
excellent care
 Focused Professional Practice Evaluation (FPPE)
◦ The follow up process to determine the validity of any
positives found through OPPE
◦ Evaluates privilege-specific competence for newly
requested privileges

14.  Indicators data can be updated on a monthly or
quarterly-basis
 Color scheme of red, yellow, and green coding to
indicate progress toward meeting the targets
 Any measure with red or yellow requires an
improvement plan
 It is called “balanced” because it tries to
distribute the goals and indicators equally across
four balanced perspectives: financial, customer,
internal business processes and employee

24. Jan Feb Mar
Jan Feb

25.  https://www.barnesjewish.org/About-
Us/Annual-Reports/2018-Hospital-
Report#safety

26.  https://www.barnesjewish.org/About-Us/Annual-
Reports/2018-Hospital-Report#safety

28. Founded in a basement in 1979 with 1½
employees, Epic develops software to help
people get well, help people stay well, and
help future generations be healthier

29.  Was founded in 1979 by Judith R. Faulkner
with a $70,000 investment[6] (equivalent to
$240,000 in 2018)
 Headquartered in Verona, Wisconsin in
 Employs 9,800 people as of 2019
 Revenue $2.5 billion (2016)
 Type Private Company

30. • More than 250 million patients have a
current electronic record in Epic
• Medical records of 64% of patients in the
United States
• Medical Records of 2.5% of patients
worldwide in 2015

35. May lead patients to falsely equate pain
management with prescription medication;
they could also incentivize providers to
prescribe more pain medication to attempt to
improve patients’ perception of care.

36. End December 2017
During this hospital stay, did you need medicine for pain?
During this hospital stay, how often was your pain well
controlled?
During this hospital stay, how often did the hospital staff
do everything they could to help you with your pain?

37. End December 2017 Begin January 2018
During this hospital stay, did
you need medicine for pain?
During the hospital stay, did
you have any pain?
During this hospital stay,
how often was your pain well
controlled?
During your hospital stay,
how often did hospital staff
talk with you about how to
treat your pain?
During this hospital stay,
how often did the hospital
staff do everything they
could to help you with your
pain?
During this hospital stay,
how often did hospital staff
talk with you about how to
treat your pain?