Dreyer Medical Clinic

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Dreyer Medical Clinic

  1. 1. 2006 Best Practices in Diabetes Care Sponsored by AMGA and sanofi-aventis U.S., Inc. April 5, 2007 – Wrap - Up Novel Interdisciplinary Approach to Diabetes Health Management: Translating Clinical Outcomes into Financial and Operational Success
  2. 2. A Brief Project Overview <ul><li>Are clinical measures enough? </li></ul><ul><li>Use “Balanced Scorecard Approach 1 ” to build metrics that are reported at every level of the organization on </li></ul><ul><ul><li>Customer Perception (internal / external) </li></ul></ul><ul><ul><li>Core Purpose Performance </li></ul></ul><ul><ul><li>Continual Innovation and Growth </li></ul></ul><ul><ul><li>Financial Success </li></ul></ul><ul><ul><li>1. Kaplan R., Norton D. Translating Strategy Into Action – The Balanced Scorecard. HBS Press. 1996. </li></ul></ul>
  3. 3. Modifications/Enhancements <ul><li>System implemented “Key Results Areas” </li></ul><ul><li>Needed to shift BSC measures to reflect organizational KRAs </li></ul>Funding Our Future Financial Perspective Growth Innovation and Growth Clinical Outcomes Internal Business Perspective <ul><li>Patient Satisfaction </li></ul><ul><li>Associate Satisfaction </li></ul><ul><li>Physician Relations </li></ul>Customer Perspective KRA - Equivalent BSC Term
  4. 4. Measuring Intermediate Success <ul><li>6 / 9 per week </li></ul><ul><li>72% / 77% </li></ul><ul><li>72% / 77% </li></ul><ul><li>25% / 20% </li></ul><ul><li>3 / 5 per week </li></ul><ul><li>55% / 65% </li></ul><ul><li>50% / 55% </li></ul><ul><li>40% / 60% </li></ul>Goal / Stretch <ul><li>POS Run Chart </li></ul><ul><li>New patients - MD referrals </li></ul>Physician Relations (Customer Perspective) <ul><li>Survey Run Chart </li></ul><ul><li>% VG internal student survey </li></ul>Associate Satisfaction (Customer Perspective) <ul><li>Clinic Reports </li></ul><ul><li>Quarterly Report </li></ul><ul><li>POS Survey </li></ul><ul><li>% of pts w/ out follow-up </li></ul>Patient Satisfaction (Customer Perspective) <ul><li>POS Run Chart </li></ul><ul><li>New patients - auto referral pts </li></ul>Growth (Innovation and Learning) <ul><li>POS Run Chart </li></ul><ul><li>Weekly % capacity used </li></ul>Funding Our Future (Financial Perspective) <ul><li>Monthly EMR reports </li></ul><ul><li>Monthly EMR reports </li></ul><ul><li>% A1C < 7 </li></ul><ul><li>% At goal BP </li></ul>Clinical Outcomes (Internal Businesses Perspective Tracking Method Measure KRA
  5. 5. Control Board
  6. 6. Long Term Clinical Outcomes <ul><li>Average A1c of patients entering the program is 8.6 </li></ul><ul><li>48% of patients with an A1c <7 would have continued indefinitely </li></ul><ul><li>We are short of our goal of 50% </li></ul><ul><li>On Monday, we are writing a 90 day action plan to get us above 50% </li></ul><ul><li>SMART plans </li></ul>
  7. 7. Physician Relations / Growth
  8. 8. Funding our future
  9. 9. Challenges? <ul><li>It’s not easy to be balanced </li></ul><ul><li>Balancing responsibilities (TIME) </li></ul><ul><ul><li>Patients / Clinic / MWU / Students </li></ul></ul><ul><li>Process of shifting to new “terminology” – KRA’s </li></ul><ul><li>Data collection – most of our data is now collected at POS </li></ul><ul><li>Concept of 90 day action plans </li></ul>
  10. 10. Future Steps <ul><li>Develop “90 Day Action Plans” for each of the KRA’s </li></ul><ul><li>SMART – Goals and Plans </li></ul><ul><ul><li>S pecific: What I am going to do </li></ul></ul><ul><ul><li>M easurable: We can see it; observable </li></ul></ul><ul><ul><li>A imed: a step toward larger goal </li></ul></ul><ul><ul><li>R ealistic: I can / will do this </li></ul></ul><ul><ul><li>T imeframes: I will have it in place by </li></ul></ul>
  11. 11. Lessons Learned <ul><li>Not all data needs to be generated via a report -control boards work great </li></ul><ul><ul><li>Keeps staff aware of progress / generates interest and excitement </li></ul></ul><ul><li>Perspective is important (administration / clinicians) </li></ul><ul><ul><li>We have learned from each other </li></ul></ul><ul><ul><li>Sometimes things don’t always seem as they appear (i.e. telephone follow-up not calculated in % Capacity) </li></ul></ul><ul><li>Focusing on one area may not necessarily improve others </li></ul><ul><ul><li>Focus on increasing new patients without increase in % Capacity Used </li></ul></ul>
  12. 12. Questions for the Group <ul><li>How are you </li></ul><ul><ul><li>dealing with unused capacity in your programs? </li></ul></ul><ul><ul><li>encouraging physician referrals to your programs? </li></ul></ul><ul><ul><li>recruiting new patients to your programs? </li></ul></ul><ul><ul><li>assessing patient satisfaction? </li></ul></ul><ul><ul><ul><li>Do you have tool you are using? </li></ul></ul></ul><ul><ul><ul><li>Response rates? </li></ul></ul></ul>

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