Purpose: To review a case study that includes challenging performance improvement issues in a hospital setting and to generate a memo that describes to hospital leadership why change in the way the hospital reviews benchmark data should change.
Description: This case puts you in the shoes of a healthcare administrator (Blanche) who has been asked to make decisions about hospital performance data using quarterly averages provided by a benchmarking service. She realizes that the current approach is flawed and she goes about finding out why by consulting with a colleague. Once she discovers the flaws in her current approach, she realizes she must influence hospital leadership to change from a static performance assessment approach to a process-oriented approaches. She realizes that this transition requires major changes in both statistical tools and methods for using benchmark data effectively to drive improvement AND a change in how the organization is structured (less vertical, more horizontal structure) This change is one of shifting to a process oriented approach which includes both the use of statistical process control as the analytic approach to monitoring performance data and a more interdepartmental/interdisciplinary approach to managing performance. Internal and external benchmarking is paramount in both approaches.
The case study is found here:
Completing the Memo
- Write a memo (1100-1500 words) to the hospital executive team in preparation for the Quality and Safety Board level committee meeting. This memo should be written by Blanche and addressed to the hospital leadership. THE WORD COUNT PROVIDES LEEWAY FOR YOU TO BE AS CREATIVE AND INFORMATIVE AS YOU CHOOSE TO BE.
The focus of this memo is to highlight the problems with the current performance management system (using benchmark average data) and to convince the hospital executive team to support Blanche and clinical services leadership to transition the ineffective performance management system to a more analytic focused, process-oriented approach.
Her explanations should address the following list of expectations. Use examples and/or analogies to help illustrate major contentions the memo. You are writing this as if you are Blanche. Refer to the resources in Module two for standard memo writing guidelines. Be sure to use bullets and bolded words to make your points as well as sections for readability and appeal.
- Introduction – the purpose of the memo
- What is wrong with the current performance management approach, in particular, the use of percentile ranking as criteria for decision making?
- Why did it often appear that, in the past, quality improved after poor results were reported in the previous quarter?
- Why have Blanche’s efforts to improve in the long term quality been ineffective?
- What is a process oriented approach consist of? (see the definition within the case and review the Finland Hospital Case study to gather more information about this)
- How will a process-oriented approach work at the hospital, and how will the hospital benefit?
- H ow would using statistical process control (SPC) and specifically run charts and control charts to monitor performance over time be different than the current approach the hospital uses?
- Find a peer-reviewed article that details the application of statistical process control as the central analytic approach to monitoring and improving performance at another healthcare organization, and explain how it supports Blanche’s recommendation.
- How will Blanche’s job change as a result of the new process-oriented approach?
- What training will be necessary for Blanche and others in the hospital to make this transition over time?