A Balanced Perspective to Perioperative Process Management Aligned to Hospital Strategy

Abstract

Dynamic technological activities of analysis, evaluation, and synthesis can highlight complex relationships within integrated processes to target improvement and ultimately yield improved processes. Likewise, the identification of existing process limitations, potential capabilities, and subsequent contextual understanding are contributing factors that yield measured improvement. This case study examines process management practices of balanced scorecard and dashboards to monitor and improve the perioperative process, aligned to overall hospital goals at strategic, tactical, and operational levels. Based on a 120-month longitudinal study of an academic medical center, this study investigates how integrated information systems and business analytics can improve perioperative efficiency and effectiveness across patient quality of care, stakeholder satisfaction, clinical operations, and financial cost effectiveness. Implications and/or limitations are also discussed.

Language of Improvement: Metrics, Key Performance Indicators, Benchmarks, Analytics, Scorecards, and Dashboards

“…Perioperative nurses and leaders use trending data to support decision making, specifically processes tied to “patient flow, patient safety, patient quality of care, and stakeholders’ satisfaction (i.e. patient, physician/surgeon, nurse, perioperative staff, and hospital administration).” 3(p1) Understanding and monitoring the various metrics using scorecards and dashboards to paint effective and useful pictures may lead to improved outcomes in perioperative settings.…”

“…Meaningful results produced from purposeful and accurate data are the foundation from which significant analysis for relevant change occurs 2 . Comparison information on a variety of improvement topics for exploration can be found in large data sources, such as the 11 Hospital Consumer Assessment of Healthcare Providers and Systems key topics or the Surgical Care Improvement Project core measures 3,4 …”

“…The terms scorecard and dashboard are frequently interchanged 11 and represent “different types of visual display mechanisms within a performance management system that convey critical performance information at a glance.” 6(p9) Using scorecards and dashboards for purposes such as “strategic, tactical, and day‐to‐day operations, coupled with internal and external best‐practice benchmarks, provide the framework for targeting improvement opportunities and evoking improvement changes to the perioperative process.” 3(p2) A dashboard is a tool for monitoring operational performance processes, and scorecards focus on the progression of tactical and strategic goals. “Dashboards also tend to display charts and tables with conditional formatting, whereas scorecards use graphical symbols and icons to represent the status and trends of key metrics.” 6(p9)…”

A Case Study Perspective to the Digital Transformation of a Hospital’s Perioperative Process

“…Surgical case volume during FY2017 was 36,736 cases over the 58 ORs and 11 endoscopy labs. UHPS focuses BPM on data-driven analysis of KPIs at strategic, tactical, and operational levels via balanced scorecards and dashboards, aligned to hospital strategy [36,38]. To this end, numerous BPM efforts have targeted multiple perioperative sub-processes to improve patient workflow [37].…”

Improving Perioperative Data Integrity and Quality via Electronic Medical Record Reconciliation

“…This CPI effort resulted in the executive team enlisting numerous task forces to address specific opportunities, which was the foundation for their current BPM approach. Since 2005, UHPS has focused datadriven analysis of KPIs to gauge process variance, identify improvement opportunities from variances, and improve end-to-end workflow [32].…”