Engaging Physicians in Dashboards development.
Creating a Data Oriented Management culture. Engaging Physicians in Dashboards development.
Participant comments on Engaging Physicians in Dashboards development.
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Streamline your docter’s payment structure along the KPI’s in the dashboard you develop
Make the dashboard relevant to the physician’s day to day practice, and easy to read and interpret, otherwise not likely to be used. Also…accurate data is important/required. For example, at our institution, on our dashboard we recieve individually our production vs budgeted RVUs, etc. It turned out that 2 FMLA’s of employees within the billing department happened within the same month, and billing and dropping of E&M charges lagged by 4-6 weeks as a result. The physician’s saw their dashboard substantially change, but not concordant with their actual work done. This caused “panic” to say the least, to have physician’s pay be so closely tied to RVU production month to month, and 30% drops were seen with many providers. After many days to several weeks, eventually the root cause was seen. So…if you use/develop a dashboard so linked to pay and production, if their is a system’s issue…be prepared to inform quickly those that need to rectify that information, as provider and physician satisfaction otherwise will loose trust in the dashboard’s accuracy.
Discuss with the physicians by specialty what they feel would be valuable to them to have on the dashboard. They may come up with items that you hadn’t considered but what physicians would find useful for quality indicators and to compare themselves to their colleagues. Whatever is selected for the dashboard must be accurate, reliable, and reproducible.
It is very important to get them engaged, they know their business better than anyone else so they will uncover the hidden data that neither IT nor operations and finance would figure out. Multidisciplinary team is the way to go with dashboards and the presence of medical, finance and operations in the setup of dashboards and gauges become informative to all parties. it is not very uncommon to see useless data being collected just because the right people were not involved!!!!
Dashboards are only useful to end-users as they address the information needs of those users. Involvement of end users is crucial to get the metrics of the dashboard right. Many physicians are really interested in metrics as long as these ar trustworthy. We developed a few dashboards for clinicians and head of departments. We brought the clinicians together with financial and operating people together and discussed what metrics would be of interest and how these would connect to financial or operating metrics. This may widely vary between specialities.
Dashboard should also (depending on the metric) be timely. Some metrics ar important to follow more or less real time, others are well be collected every months or so. This frequency of refreshing numbers is also an important issue to discuss with the end-user. Finally, after having build an dashboard, clinicians should be asked for face-validity of the metrics; are the numbers in range of their expectations. If not their should be a collaborative effort to find out why the metrics are not up to expectations. Unless this step is taken, dashboard won’t be embraced.
Dashboards are only as good as the data that gets put in. It is critical that the data is accurate, validated, and up to date. Physicians will be quick to dismiss data if they feel it is inaccurate. Having metrics that are actionable (ie- can be acted upon to make improvements) are also key. We have seen inconsistent data in some of our dashboards previously and it was a disaster. We’ve spent a lot of time and money now getting new dashboards up and running. I know feel we have to “sell” them to the providers so that they will use them- which is ultimately to their advantage.
I think data is very useful not just to drive performance but also to reduce waste and as a platform for continuous improvement. However, a few elements needs to be in place for its success
1) Deep engagement with users at all levels to make sure what is collected and available would be useful
2) Data source must be accurate
3) Data must be up to date and ‘live’ if possible
4) Utility and usefulness of the data should be shared with institution from different users to further enhance user adoption
5) The business case would be if the use the dashboard lead to improvement in performance, and reduction in waste, so these needs to be quantified and tracked (these KPI should in fact be key data collected and reflected in the dashboard), so that one can know if the investment is useful as setting up the dashboard and data collection do need a lot of investments and resources
I strongly believe in the importance of dash boards and the knowledge it provides, I think the start point is a leadership that believes in such tools and how to use it in intelligence and efficient way to improve bussiness outcomes from all sides, wether financially or related to patient safety and quality of health care services.
I have weekly meetings with my medical heads of departments and a monthly meeting with all doctors where I present to them some of the results I get from dashboards related to their departments and the KPI’s we get, and actually they look forward for such presentations and they actively participate in the discussions after wards.
Not all doctors might be a candidates to participate in development process, we ask for volunteers and we keep the door open for any new ideas generated by them, and then we focus on physicians whom we feel their engagement added value to the development process and we choose some of them as memebers in the development committee.
Having a physician as a member in the development will increase the acceptance and engagement of other physicians towards the results generated by such dash boards.
Within our Health System, we created reporting teams charged with creating dashboards. While these teams always had representation from Finance, IT, Operations, etc., each team was led by a clinical stakeholder. For instance, the surgical reporting team was led by a chair of surgery (MD) who was extremely interested in data and process improvement. This MD not only created the vision of what information provided value, he was able to identify process improvements within & outside of the operating room simply through the development of the dashboard. Since this MD was highly respected by his peers, we not only secured buy-in but other clinicians came forward with interest to participate. Similar reporting teams were developed for various clinical & non-clinical functional areas.
Dashboards are extremely valuable if data presented is meaningful to the users. End users have to be a part of designing and have to trust that the data is not collected for any other reason but to be transparent and improve. There are real issues at times, when the obvious problems become visible across the organization. Its a tool but also a way of thinking and organizational culture. Dashboards merely display data and cant solve problems.
Dashboards can be an effective and useful tool if properly developed and distributed. The key components to utilization at our institution revolve around user friendliness and functionality. Clinicians, chronically time compressed, have little patience for dashboards that are difficult to decipher and ponderous to use. Additionally, the data presented should be relevant to the user, accurate, and as near real time as possible. We use multiple dashboards that present the same information but segregated by time frame each giving a different perspective on the same information, and each actionable in different ways. We audit our data semi-annually to determine its accuracy. Having the primary stakeholders intimately involved in the data elements presented also helps to improve engagement as well as understanding of the data presented.
Dashboards are extremely valuable when the data is meaningful. I believe if the dashboards are utilized and disseminated at multiple forums throughout the hospitals and health system there is greater buy. In addition, we are recently also focusing on the value of the numerator. Rates can be analyzed in many different ways, but the absolute number is real and when it comes to mortalities and HAC’s it means an individual patient. That resonates with the providers.
Dashboards can be powerful tools or instruments of deep frustration depending on how they are designed, populated and utilized. A few tenets you might consider when developing dashboards for physician colleagues include:
1) Select metrics that are relevant, timely and specific to mission
2) Be flexible
3) Start small and shoot for a high level of data integrity
4) Include the Physicians in the design and selection of metrics
5) Refresh and tweak as necessary
The best way to have a meaningful use of a dashboard is to engage physicians to be part of creating it. Each department has it’s own metrics that they are interested as well as overall data that is based on the hospital. We have a cloud-based HIPPA compliant dashboard that can be extremely personalized and used on your phone. Going through the data in a weekly basis meeting forces everyone to use it.
The dashboard is potentially a valuable tool. However, it should not create another chore for the physician within already busy clinic day. Thus, if part of the dashboard is a function to click when patient is placed in room, seen by RN, seen by MD, ready for checkout etc., have a centralized person click these functions on behalf of the clinician who simply verbally reports where they are going, that the patient is ready for checkout etc.
Dashboards are very useful, also for doctors.
The most important point is to consult the MDs, which data are of relevance for them for handling a patient, a unit or department.
Successful examples how dashboards have been useful in the past will be of great help to get physician buy-in. Moreover, the dashboard should not be perceived as a measure to simply control personnel activity and productivity.