BI is not an OPTIONGeorgette Loubnan

Agenda – BI is not an Option▪Drivers for Enterprise Intelligence▪What’s achieved in 2 years▪ Improvements and Optimizations▪Conclusion

Drivers for Enterprise Intelligence

It is a culture shift

Total cost per year on data mining,

rework, report

requests and

development =

$1,050,000+

Total Staff assisting in report requests,

data mining

and analysis = 50+

Budget was bleeding!Not counting the Opportunity Costs

Legacy systems were obsolete and numerousLicensing costsOn Going MaintenanceMultiple source of truthMultiple systems – multiple loginsManual manipulation of dataNo data governanceNo visibility into the business realityOne time requests and no true

analyses

BI is not an Option!

Analysis TypesHistorical (what happened)Operational (what is happening now)Analytical (why did it happen) Predictive (what might happen)Prescriptive (what should I do about it)Exploratory (what's out there that I don't know about)

Achieved in 2 yearsHalf way through the vision

Talent Waste!Operational

crippling!More time

finding dataReactive

business

Realized Gain!

Operations self serve!

More time Analyzing

Proactive business

Improvements and Optimizations

Still have a long road ahead

Glucose Management

Labor Turnover

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Analyze labor turnover data in an effort to form meaningful plans to reduce turnover

Glucose Management

Glucose Managem

ent

Click icon to add picture Streamline the process for notifying the

multidisciplinary team members when a patient with uncontrolled diabetes enters one of our hospitals

Monitor physician performance around glycemic control and their use of the recommended regimen related to insulin

Monitor how frequently the 3 events around mealtime and insulin occur in the right sequence and within the recommended time frame

Identify what interventions are having an impact

Ability to see the number of hyperglycemic (high blood sugar) and hypoglycemic events daily and in each unit and room

Glucose Management

Glucose Management

Hospitalist Dashboard

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The dashboard will provide information updated daily from Meditech and NextGen for the defined metrics. Wherever possible, data will be shown by month with trends.

Hospitalists will be able to track their performance in various incentive-based metrics relative to industry benchmarks and all hospitalists in SIH MG.

Information and metrics will fall into 4 main groups: Admission & Discharge volumes, Productivity, Readmissions, and Resource Management.

Glucose Management

Cardiac Managem

ent

Click icon to add picture Increase to 75% percent of CABG patients

with ICU post-op LOS of <= 2 Reduce median ventilation hours and

pulmonary complications (indicated by percent of patients with prolonged ventilation of over 24 hours) to meet national benchmark levels

An analysis of data in the dashboard during a meeting with the Cardiac Surgeons and Anesthesia back in late January 2016 resulted in changes designed to reduce vent times. Anesthesia agreed to decrease the level of muscle paralytics so the patients could wake up quicker in the ICU. This has decreased our extubation time from 15 hours to 7.0 hours (right hand graph dark blue line). National average is 6 hours. Big change! We could not have done it without the dashboard. It gives us real time data that helps us update our team members how well doing

We hit out goal of extubating 25% of CABG patient within 8 hours! First time in 4 years

Glucose Management

Pulmonary Managemen

t

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The COPD/Pneumonia team believes this represents an improvement opportunity for patients receiving care for COPD and Pneumonia

Overall mortality rates for patients discharged with a diagnosis of COPD/Pneumonia are 1.2%1, 1.9%1 and 3.1%1 at MHC, HH and SJH respectively and with benchmark at 4.4%1, 3.9%1 and 2.1%

There is opportunity for improvement in the implementing evidence based care and reducing length of stay for patients with pneumonia or COPD (ALOS 3.88 days1, 4.17 days, 3.30 days1 at MHC, HH and SJH) with peer being at 4.61 days1, 4.52 days and 3.86 days

The 30 day readmission rate for pneumonia and COPD is at 13.4%, 13.6% and 12.1% for MHC, HH and SIH respectively with benchmark being at 13.2%, 19.3% and 8.0%

Nursing Dashboard Immediate realized gainSIH has approximately

168 Occupied Inpatient Beds on an average day (includes Rehab and ICU, excludes Pediatrics and OB)

Nurses indicate they would like to be aware of Critical Labs, Foleys and Braden Score four times per day. LOS, Readmissions and Restraints once per day.

It takes 2:45 minutes per patient to check Critical Labs, Foleys and Braden Score and approximately 32 mouse clicks

▪ 168 Beds X 2:45 Minutes per check X 4 checks per day = 2072 Minutes per day or 12,775 hours per year. This is the equivalent of 6.1 FTEs or $403,690 per year based on the average hourly wage of a Charge Nurse.▪ It also saves 7,848,960 mouse clicks per year

Other Feedback – Line of service Directors

▪ Consistent data is reviewed by the team.▪ You eliminate multiple teams collecting the

same data with different outcomes▪ Saves time from collecting data to

having more time to review and seek solutions.

▪ Because the data collection is pulled directly from software, this has decreased questions of validity.

▪ Quick identification of trends with the graphs.▪ One example: Vent times and blood

usage, it was identified that increase blood usage, increased vent times.

▪ Easy access to date that is needed for the Manager’s Operations Review. ▪ Easy comparison of year to year, quarter

to quarter or month to month. ▪ During the building of the applications, it

has brought all stake holders together. All team members have a clear understanding of data and the why specific data is needed.

▪ I use the Surgical Management app to look at specific surgeon case volumes, case volume by service line, Monthly Case volume, Add-on Case volumes and Cancellation rates on Day of Surgery.

▪ We use these measures to monitor metrics for the individual facilities and SIH overall.

▪ We are now ready to start managing the scheduled versus actual case times to determine if the estimated case times are accurate. I will be training the charge nurses to use the dashboard to collect this information.

▪ The Surgical Management app allows easy access to the information and is very user friendly. I have set up some favorite reports and use these to capture the metric data every month. That way I am measuring the data the same way every month and know there is not a discrepancy in how the report fields are chosen.

More Feedback

“There are several of us out here producing various

reporting products and it all needs to be a concerted effort to produce meaningful data for our leaders to make informed

decisions” – HR Manager

Governance

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Starts with the Business Owners and is facilitated by IT

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