Using Key Performance Indicators to Reduce Perceived Perioperative Complexity and Improve Patient Workflow

Abstract

This study examines the development and use of balanced scorecard metrics as key performance indicators within each stage of the perioperative process to enable business process management across the entire process to gauge performance and target improvement opportunities. The identification of existing limitations, potential capabilities, and the subsequent contextual understanding are contributing factors toward perioperative improvement. This paper identifies how dynamic technological activities of analysis, evaluation, and synthesis applied to internal and external organizational data can highlight complex relationships within integrated hospital processes to address root causes rather than symptoms and ultimately yield improved capabilities. This case study investigates how integrated information systems can identify, qualify, and quantify perioperative performance indicators to measure improvement based on a 157-month longitudinal study of a large, 1,157 registered-bed teaching hospital. The theoretical and practical implications and/or limitations of this study's results are also discussed with respect to practitioners and researchers alike.

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

“…Pratt et al [31] suggests EMRs and healthcare IS fit the computer supported cooperative work (CSCW) paradigm [12] and should be viewed via a CSCW lens. Moreover, the CSIS scheduling information and nursing EMRs yield aggregated surgical case (i.e., patient) data leveraged as KPI metrics to further understand, manage, and improve perioperative workflow, resources, and performance [36,38]. The following sub-sections discuss digital maturity, defensive for offensive IT impact, and digital transformation CSFs with respect to the literature, case background, and observed effects.…”

“…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].…”

“…The BPM approach in managing the UHHS perioperative process via CSIS data has achieved an extraordinary level of operational excellence, as evidenced by its improved patient flow and KPI metrics [36,37,38]. In turn, operational excellence positions UHHS to pursue external customer experience centered on enhanced collaboration between perioperative stakeholders (e.g., healthcare providers, patients and their families).…”

Improving Perioperative Data Integrity and Quality via Electronic Medical Record Reconciliation

“…UHPS embedded the QCC process depicted in Figure 2 as part of the automated extraction, transfer, and aggregation of KPIs across perioperative sub-processes. Perioperative process complexity [14] broken-down into sub-processes demonstrates a proven approach to understanding complexity by reducing the phenomenon perspective into smaller more manageable and comprehendible units [34]. The embedded QCC process ensures data integrity and quality of sub-process KPIs, extracted from nursing documentation EMRs, to measure process performance and target improvement opportunity.…”

Targeting Perioperative Performance Aligned to Hospital Strategy via Digital Transformation

“…Table 2 details a complete listing and timeline of UHPS' perioperative improvements. UHPS focuses BPM on data-driven analysis of KPIs at strategic, tactical, and operational levels via balanced scorecards and dashboards, aligned to hospital strategy [31]. To this end, numerous BPM efforts have targeted multiple perioperative sub-processes to improve patient workflow [30].…”