Scorecards & Dashboards:
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1 Scorecards & Dashboards: If you can measure it, you can manage it The 15 th Annual Region IX Management Training Conference FireSky Resort and Spa Scottsdale, Arizona Greg Brandenburg Chief Executive Officer
2 Columbia Basin Health Association 14 th Ave Medical Center Othello Family Clinic Wahluke Family Clinic Connell Family Dental Clinic
3 Who We Are Founded in 1973, CBHA s mission and purpose is to provide equal access to quality health care to all persons regardless of age, sex, color, ethnicity, national origin, or the ability to pay. CBHA won the first ever HIMSS Davies Community Health Award of Excellence was the fourth time CBHA has placed in the top five Not-for-Profit Companies to Work For. CBHA has been accredited by the Joint Commission since In 2007, CBHA won the William O. Robertson Patient Safety Award for the Medication Reconciliation & Consultation Program
4 Course Objectives! Understand How You Can Develop and Implement a Scorecard/Dashboard System to Improve Your Organization Performance! Identify Performance Measures to Track! Identify Sources of Data for Reporting! Identify Benchmarks
5 What Are Scorecards & Dashboards?! A Set of Documents That Use Technologies and Processes That Gather Data to Understand and Analyze Business Performance.! If You Want To Develop a Scorecard/Dashboard System, a Quick & Painless Journey Cannot Be Promised.
6 Steps To Implementation! Software Applications! Technology! Mine The Data! Develop Processes! Metrics! Incentives! Culture! Sponsorship
7 Why Use Scorecards/Dashboards?! Organizations That Want To Be Competitive Must Have Some Attribute At Which They Are Better Than Their Competition! As A Tool To Measure Organizational Performance! As A Tool To Communicate And Provide Feedback To All Stakeholders! As A Strategic Management Tool To Outline Measures Important To Your Leadership Team! As A Goal-Setting Tool
8 What Should We Measure?! Things that are important to: " Board: How can we maximize the value and effectiveness of our mission? " Leadership & Supervisor Teams: How can we improve our processes to deliver our services better, faster, and more cost effective? " Employees: How can we support our processes through improved knowledge, skills, and technology? " Patients: How well do our products and services meet the needs of our patients?
9 What Should We Measure?! Look For Common, Repeating Program Elements " Overtime (%) " FTEs " Attendance (CBHA exception points ) " Cycle Times " Patient Complaints " Encounters
10 How Should We Measure?! Organization Wide " Billable Patient Visits " Patient Payor Source " Patient Wait and Cycle Times " Complaints by Department " Managed Care Enrollment by Program " Average Days in A/R " FTE s Compared to Budget " Overtime as % of Worked Hours Compared to Budget
11 Encounters Organization Wide Billable Patient Visits '08 Budget > 11,500/Month 14,000 13,000 12,000 11,000 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 - Total M edical Dent al Vision M SS/M CM Other Prof essional
12 Patient Complaints Organization Wide Patient Complaints < 9 Complaints Other Lab EyeCare Nursing Patient Services Administration Dental Medical Pharmacy
13 How Should We Measure?! Clinics Othello Family Clinic Wahluke Family Clinic 14 th Avenue Medical Center Othello Family Dental Clinic Wahluke Family Dental Clinic Connell Family Dental Clinic Othello EyeCare
14 Encounters Nursing Department Visits/FTE/Day '08 Budget > 10 visits Othello Mattaw a 14th Avenue
15 Encounters Othello Family Clinic Medical Visits/FTE/Day '08 Budget PS >17 / Nursing > Patient Service Nursing
16 How Should We Measure? Programs/Departments Billing WIC Call Center Patient Benefits Human Resources IT Support Services Case Management Lab Medical Providers Nursing Dental Providers Pharmacy Chronic Disease Mgmt
17 Encounters Medical Providers Encounters / Provider Hours '08 Budget =
18 UDS Grantee Comparison Report - Medical UNIVERSAL Averages National Percentiles Grantee Grantee WA National Rural Large 25th Median 75th Percentile CY 2005 U3.21 Family Practice Productivity 5,006 3,687 3,963 4,027 4,075 3,146 3,781 4,448 88% U3.23 Internal Medicine Productivity 3,474 3,205 3,881 4,045 3,941 3,109 3,790 4,483 37% U3.24 OB/GYN Productivity 6,174 3,808 3,636 3,727 3,649 2,617 3,720 4,595 93% U3.25 Pediatric Productivity 7,610 3,352 3,985 4,201 4,068 2,923 3,697 4,387 99% U3.26 Overall Physician Productivity (excl. spec. phys.) 5,208 3,608 3,928 4,045 4,015 3,160 3,726 4,292 94% U3.27 NP/PA/CNM Productivity 3,985 3,016 2,850 3,041 2,969 2,211 2,787 3,316 92% U3.272 PA Productivity 3,985 3,179 3,042 3,162 3,176 2,247 2,935 3,579 84% U3.28 Medical Team Productivity 5,907 4,213 4,312 4,482 4,403 3,657 4,255 4,808 96% CY 2006 U3.21 Family Practice Productivity 5,059 3,371 3,858 3,961 3,971 3,086 3,703 4,348 90% U3.24 OB/GYN Productivity 6,285 3,281 3,596 3,673 3,625 2,634 3,558 4,585 92% U3.25 Pediatric Productivity 7,844 3,310 3,935 4,129 4,025 2,963 3,669 4, % U3.26 Overall Physician Productivity (excl. spec. phys.) 5,349 3,349 3,846 3,969 3,937 3,080 3,676 4,261 96% U3.27 NP/PA/CNM Productivity 4,233 2,929 2,879 3,076 3,001 2,262 2,810 3,356 95% U3.272 PA Productivity 4,233 3,135 3,072 3,232 3,189 2,305 2,923 3,668 90% U3.28 Medical Team Productivity 6,107 3,933 4,256 4,464 4,338 3,635 4,207 4,796 96% CY 2007 U3.21 Family Practice Productivity 5,220 3,574 3,830 3,881 3,943 2,979 3,682 4,289 91% U3.23 Internal Medicine Productivity 1,932 2,818 3,755 3,944 3,850 2,843 3,605 4,287 6% U3.24 OB/GYN Productivity 6,769 3,529 3,616 3,776 3,642 2,566 3,429 4,546 93% U3.25 Pediatric Productivity 7,230 3,356 3,937 4,206 4,019 2,927 3,678 4,363 99% U3.26 Overall Physician Productivity (excl. spec. phys.) 5,300 3,467 3,826 3,953 3,921 3,039 3,638 4,208 94% U3.27 NP/PA/CNM Productivity 4,513 3,030 2,868 3,071 2,998 2,223 2,775 3,380 97% U3.272 PA Productivity 4,513 3,244 3,062 3,198 3,224 2,190 2,860 3,646 95% U3.28 Medical Team Productivity 6,161 4,072 4,248 4,463 4,336 3,568 4,205 4,737 96%
19 UDS Grantee Comparison Report - Dental UNIVERSAL Averages National Percentiles Grantee Grantee WA National Rural Large 25th Median 75th Percentile CY 2005 U3.31 Dentist Productivity 4,438 2,893 2,720 2,773 2,805 2,005 2,467 3,088 97% U3.32 Dental Hygenist Productivity 2,378 1,000 1,298 1,239 1, ,291 1,623 95% U3.33 Dental Team Productivity 4,486 2,803 2,700 2,722 2,784 2,035 2,463 3,066 97% CY 2006 U3.31 Dentist Productivity 4,526 2,945 2,702 2,764 2,781 1,996 2,525 3,089 97% U3.32 Dental Hygenist Productivity 2,692 1,006 1,379 1,282 1, ,338 1,731 96% U3.33 Dental Team Productivity 4,648 2,841 2,711 2,729 2,789 2,041 2,534 3,043 97% CY 2007 U3.31 Dentist Productivity 4,707 2,886 2,669 2,735 2,741 1,967 2,439 3,040 97% U3.32 Dental Hygenist Productivity 3,421 1,070 1,341 1,235 1, ,300 1,703 99% U3.33 Dental Team Productivity 5,008 2,812 2,671 2,686 2,746 1,987 2,491 2,995 98%
20 Encounters Billing Department Encounters/Billing FTE 1,800 1,600 1,400 1,200 1, '08 Budget = 1200 Enc/FTE Target
21 Encounters Lab Department % Receiving Lab Services 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Othello Mattaw a 14th Ave
22 Encounters - Support Services Visits 2,000 1,800 1,600 1,400 1,200 1, Non-Billable Outreach In Clinic Behavioral Health
23 Computer Status - IT Computer Status For Sale Pending Storage WIP Disposed Active
24 Encounters Patient Benefits < 3% 5.00% 4.00% % Self Pay Visits 3.00% 2.00% 1.00% 0.00% % Othello % Mattaw a %14th Avenue
25 All Providers - Dental All Providers-Dental Encounters No Charge Walk ins Center Cancels Wait times Provider time No Shows Charges Dec-07 2, $ 388,467 $ 162,145 8, ,626 $ $ Jan-08 2, $ 450,326 $ 210,592 9, , Feb-08 2, $ 465,409 $ 175,669 9, , Mar-08 2, $ 454,408 $ 190,180 9, , , $ 434,125 $ 195,275 8, , , $ 428,099 $ 184,334 8, , , $ 481,162 $ 162,120 9, , , $ 452,164 $ 208,236 8, , , $ 503,002 $ 195,134 9, , , $ 458,912 $ 164,029 8, , Oct $ - $ Nov $ - $ YTD 25, ,883 1, ,439 4,516,074 1,847,714 90, $ $ Annualized 30, ,260 1,278 1,727 $ 5,419,289 $ 2,217, , %'s 0% 7% 4% 5% 41% 66% 41% Receipts RVU's Days in clinic Clinic days PL Balance Charges per Encounter Receipts per Encounter RVU per Encounter Enc per days in clinic
26 All Providers - Medical All Providers-Medical Encounters No Charge Walk ins Center Cancels Wait times Provider time No Shows Charges Dec-07 6, $ 1,084,858 $ 494,242 8, ,799 $ $ Jan-08 8, $ 1,280,278 $ 531,150 10, , Feb-08 8, $ 1,353,047 $ 504,529 10, , Mar-08 8, $ 1,409,581 $ 594,193 10, , , $ 1,432,462 $ 599,094 11, , , $ 1,334,048 $ 562,643 10, , , $ 1,367,090 $ 604,434 10, , , $ 1,527,463 $ 565,624 11, , , $ 1,391,739 $ 552,502 10, , , , $ 1,426,876 $ 620,499 10, , Oct $ - $ Nov $ - $ YTD 81, ,484 2, ,352 13,607,442 5,628, , $ $ Annualized 98, ,181 2,423 5,222 $ 16,328,931 $ 6,754, , %'s 1% 10% 2% 5% 41% 90% 41% Receipts RVU's Days in clinic Clinic days PL Balance Charges per Encounter Receipts per Encounter RVU per Encounter Enc per Days in clinic
27 Data Particulars! Show Progress At A Glance " Running 6-months " 2 prior fiscal year averages " More Elements Than You Can Fit On A Graph? " Include data sheets for supervisors & leadership! Show targets where appropriate
28 Call Center Scorecard 8.00% 7.00% 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% OT < 5% Number of Abandoned Overtime Hours Equal or less than 3% Shift to Call Volume Overlay % Ovt Budget % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Full Time Equivalents '08 Budget = 11 Employee Utilization Logged in 85% of Worked Hrs Avg Calls/Day Non-Worked Worked % Logged % Phone % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Occurrences Per FTE/Yr < 12 per FTE/Yr Service Factor Greater than 90% in 30 Appointment Source Walk-in appointments are not included % TSF Goal 16.00% 14.00% 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% 7:00 AM 9:00 AM 11:00 AM 1:00 PM 3:00 PM 5:00 PM 7:00 PM Hours Worked Incoming Calls ,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 All Depts Call Center
29 Call Center Detail Summary ~ 13 Month Trend ~ Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Clinic Days Overtime Hours Regular 1,607 1,608 1,523 1,840 1,619 1,504 1,744 1,632 1,816 1,912 1,776 1,808 1,869 1,617 1,716 PL Overtime Total 1,808 1,780 1,699 2,058 1,788 1,722 2,005 2,034 2,049 2,114 1,865 1,975 2,047 1,926 1,907 % Ovt 2.21% 1.82% 1.18% 1.53% 2.34% 3.09% 2.70% 4.99% 1.94% 2.37% 1.38% 1.12% 0.59% 3.02% 1.44% Budget 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% Full Time Equivalents Worked Non-Worked Total FTE's FTE Budget Occurrences per FTE/Yr Occurrences Number of Abandoned % Calls 2.08% 3.20% 3.75% 3.64% 5.34% 4.23% 2.47% 2.18% 2.57% 2.32% 1.98% 1.79% 2.47% 3.58% 2.59% Employee Utilization Worked 1,647 1,641 1,543 1,872 1,661 1,558 1,798 1,734 1,856 1,962 1,802 1,830 1,881 1,675 1,744 Logged in 1,407 1,392 1,345 1,576 1,395 1,372 1,614 1,543 1,627 1,669 1,523 1,612 1,616 1,439 1,475 % Logged 85.43% 84.86% 87.14% 84.21% 84.00% 88.07% 89.78% 88.99% 87.66% 85.09% 84.51% 88.11% 85.92% 85.88% 84.59% On Phone % Phone 36.25% 42.32% 43.00% 43.65% 46.80% 44.79% 43.20% 43.88% 39.77% 36.87% 34.46% 40.97% 39.86% 46.14% 42.89% Total 3,652 3,728 3,551 4,266 3,834 3,628 4,189 4,038 4,221 4,355 3,946 4,192 4,247 3,886 3,967 Service Factor % TSF 91% 85% 84% 83% 76% 79% 86% 88% 84% 86% 87% 89% 86% 80% 85% Goal 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% 90% Shift to Call Volume Totals Shift Time 1, , , , , , , , , , , , , , , Calls Offered 31,029 31,780 30,291 35,636 34,530 31,494 37,155 36,458 37,087 38,967 34,617 35,761 38,402 38,300 37,786 Average Calls per Day Calls Offered ,594 1,549 1,727 1,575 1,689 1,736 1,766 1,771 1,648 1,703 1,746 1,824 1,799 Appointment Source All Depts 10,255 11,977 10,666 12,916 12,893 11,115 13,307 12,981 13,595 13,802 13,134 12,659 13,702 13,520 13,426 Call Center 6,577 6,778 5,918 6,924 7,519 6,169 7,222 8,106 8,324 7,940 6,906 6,690 8,446 8,503 8,098
30 Benchmark Sources! In-House Budget " Building Blocks of Budget! UDS Data " Nation and State-Wide Statistics " UDS Managerial Training! Surveys " Milliman " MGMA " NACHC
31 Getting the Job Done! Leadership Support & Commitment " Roll-Out Timeline! Dedicated & Knowledgeable Personnel! Accountability " Praise " Performance Improvement Committee " Performance Evaluation Goals Reliable Monthly Cycles " Due Dates! New Supervisor Training on Scorecards
32 Prominent Placement
33 The Ties that Bind: Nursing! Linking the Scorecard to the Incentive Plan! Patient Complaints! PHQ Screens! Attendance! Immunizations! Wait Times Occurrences Per FTE/Yr < 12 per FTE/Yr % 98% 96% 94% 92% 90% 88% 86% 84% 82% 80% Patient Complaints < 9 Complaints Immunization Compliance > 95% Other Lab EyeCare Nursing Patient Services Administration Dental Medical Pharmacy Othello Mattaw a 14th Avenue % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Medical Cycle Times Wait Time < 15 Minutes PHQ Screening 85% PHQ-9 Screening Completed for Chronic Care 30.5% 34.2% Jan-08 Feb % Mar % 60.7% 87.1% 93.0% 94.3%93.5% Oct-08 Nov-08 Combined Provider Wait Dec-08
34 Useful Tools! Introduction to The Balanced Scorecard: Nine Steps To Success by the Balanced Scorecard Institute and the Strategy Management Group, Inc.
35 Useful Tools! Competing on Analytics by Thomas H. Davenport and Jeanne G. Harris
36 Questions?! Best wishes to your organization as you implement a Scorecard/Dashboard System of your own.! Visit us at:
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