Newsletter for April, 2000
Swain & Associates,
Healthcare Consultants in Accreditation and Compliance
St. Petersburg, Florida

Dear Colleague:

THE DATA BUG – THERE’S NO WAY TO ESCAPE ITS BITE

All the heads turned toward the light, the multiple sets of eyes focused on the ….GRAPHIC!! Yeek – what happened to the multi-paged handouts, the rows and rows of text, the monotonous reading of the obvious, the submission of data to the annals of negative findings?

There is no way to get around it. Meaningful graphics have found their way into our lives. Just check out the expectations of the JCAHO. Now the issue is not "getting ready", it is "staying ready". The traditional 3-year surveys have other siblings now. Some of the brothers and sisters are:

• Random unannounced surveys (RUS) – the topic that heads the list of non-compliance is "aggregation and analysis of data". In addition, ad lib
• Sentinel events evoking root cause analysis,
• ORYX data of all types within networks, i.e. Long term care, home care, and
• Clinical practice guidelines all require data that immerses the processes into scrutiny.

So, what’s your approach to getting the troops rallied up to see the big picture? We know the truth in the statement, "What gets measured, gets managed". We can see why the budget is managed. The CFO demands budget "variation analysis" on the difference between the "predicted" and the "actual". The report goes monthly. So the data points could be graphed on a run chart. The effect of action taken to bring the actual into line can easily be seen as the points are plotted. This is where the rub is – seldom do people actually plot the numbers, if they did, this would be a starting place for the manager to delve deeper into the process, educate or elect to ignore the topic altogether.

If we designate a "Clinical Practice Guideline Commissioner" would we have the mandate, "variance analysis" on the merits of the path? Who owns that Clinical Path process anyway? If there are multiple owners is there a central guru? For us in the business of quantifying the cost benefit ratio of improvement efforts, this is a must. The fact that the JCAHO is now requiring it provides a forum for us to round up the ponies and put them all in a corral and ask the questions – "What works, what doesn’t" and "Why?"

Try using some of the data that exists in pathways that the staff uses. Get them excited to change by showing them a thing or two. Think about using a strategy like this:

• Round up all the pathways (or whatever your organization calls them) and commission a grand "owner".
• Establish what the merits are for each of the clinical practice guidelines.
• Set up a timeline for measurement and reporting. Be sure the physician owners are included.
• Use sampling techniques – do not wear the staff out doing 100% data collection. But determine if the clinical practices actually benefit your community in terms of costs, improving outcomes, and better education of patients and families. Or are the clinical practice guides a burden, paper chase or an albatross across the neck of your staff.
• Take the appropriate action!

Then it will be your turn at the podium. The lights will go down, the graphics will shine on the successes or plans for success your organization is making. It gets no better than this!!

Workshops and Educational Sessions that I will be participating in this spring are listed below. It would be great to catch up with you at one of them! Call the office for more detail (704-708-6591)

April 11, 2000 Florida Hospital Association, Orlando, FL "Managing Performance for Success: Any Data Will Take You-But, where are you going?"

April 13 & 14, 2000 Illinois Association of Healthcare Quality Spring meeting in Arlington Heights, IL

Conference Theme: The Millenium Challenge: Creating Energy for Change.

Best wishes to you in your constant vigilance to improve the performance of your facilities. I am continuing to update the web site (www.snaconsulitng.com) with practical enhancements to our business. Please feel free to e-mail me if you find something that others could benefit from.

Good luck and

Best Wishes,

Paula Swain, MSN, CPHQ

Swain & Associates

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