Healthcare organizations around the world face the challenge of creating Key Performance Indicators (KPIs) that clinicians actually care about. The problem is, it’s usually the administrators who lead these efforts, and they usually use administrative data to drive the metrics and … surprise, the KPIs end up being very administrator-focused.
But that’s rarely the intent. Healthcare leaders often introduce KPIs with a goal of driving improvement through awareness and understanding.
So how can an organization create KPIs that clinicians care about? Here are 4 steps:
Step 1: Engage clinicians in the design process
When introducing a change, most would agree that a winning strategy is to involve people who will experience the change in the design process. Clinicians are no exception. They are often very numbers-driven, but want the numbers to mean something to them. The level of consultation and engagement doesn’t have to be a lot … it can be seeking advice from a few key clinical leaders and influencers, or it could be a full-blown focus group with stickies. What’s important is that the clinicians have had the opportunity to give input and feedback.
Generally speaking this is best done with a group of 5 to 10 representative clinicians, led by a facilitator who is good at condensing big ideas and focusing on the biggest issues. It’s also ideal to have a “data person” present, though, the facilitator should take special care not to limit the KPIs to the available data. Try to encourage this group to brainstorm their top 10 KPIs … it’s important to avoid what Brad Hams (author of Ownership Thinking) describes as going to the “KPI Buffet” where people select way too many KPIs to the point that the information is overwhelming.
Step 2: Think about what the clinicians will do differently based on the KPI
After brainstorming the top 10 KPI candidates, the next exercise is to focus on ensuring the KPIs are actionable. If a KPI is actionable it will:
- Tell you how you are performing on something that you can influence, and
- Tell you in a time frame that you can do something about it
The “something you can influence” is a key concept. There is no point in monitoring KPIs that people have no control over. In complicated environments like healthcare, where many different people contribute to performance, it’s fairly common for everyone to think the problem is because of someone else. Borrowing again from Brad Hams, you can identify the clinician that has the most influence on a given KPI and then put their name next to the KPI as the KPI owner. This will go a long way towards making at least a few clinicians care about the KPIs!
Ideally, through this lens of making the KPIs actionable, you will have decreased your list from 10 KPI candidates to 5 or less.
Step 3: Keep it to 3 KPIs
As much as we would all like to fix everything right away, the reality is that most people, departments and healthcare organizations can only really focus on a few key areas at one time. So, push the design team to select the 3 best, most actionable, most relevant, and most impactful KPIs. By the time that you’ve charted these KPIs over time relative to their targets, there will still be lots to look at.
Once these first three KPIs are well on target and under management, they can be removed from your top-of-mind monitoring reports and replaced with other actionable KPIs that didn’t make the list.
An alternate possibility is allow 3 KPIs in each clinical area. For example, there are KPIs that are relevant to Surgery (such as post-operative infection rates, or compliance with the surgical checklist) that would not be relevant to Medicine.
Step 4: Put the KPIs into action, and stick with it
There will likely be some work in actually getting the data for these KPIs in a clean, accurate and reliable format. As mentioned before, some of these KPIs might not have data sources yet, and some ground work will need to be done to start collecting the data prospectively. Bear in mind that it’s much more valuable to have manually collected data feeding into an actionable KPI than pre-existing data sources feeding into a KPI that can’t be influenced.
To put the KPIs into action:
- Post them publicly
- Build a habit of reviewing them as a routine part of standing clinician meetings
- Publicly celebrate when targets are met, making sure to recognize each individual who contributed to the success
- Retire the KPIs when they are under management, and when there are more important KPIs for the top 3 positions. Resist the urge to grow the KPI list.
If you have stories about how you’ve created KPIs that resonated with clinicians, please share them. And as always, please feel free to connect
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