Organizations in private duty home care are increasingly embracing the use of data dashboards to measure and manage performance and benchmarking is becoming commonplace. The goal of course is for these dashboards to help us make well-informed business decisions and understand how we perform overall in relation to our strategic priorities and goals. They should be geared towards learning rather than judgement. However, this all starts with the premise that we already know as leaders what kind of information we need and what we should include on these dashboards.
A recent session from The Studer Group’s Gratitude Symposium presented by Robert Lloyd, Ph.D., Vice President of the Institute for Healthcare Improvement, focused in on organizational dashboards and why some of us might not be creating in our dashboards in a way that can be the most beneficial. His session entitled: So, What’s on Your Dashboard? Focused on the things that leaders should consider when constructing as well as utilizing these important tools in the best and most valuable way possible.
Start by Choosing Data Over Information:
Lloyd noted that for some, there can be a tendency to confuse data and information when beginning their journey on organizational dashboard creation. “Data refers to raw facts and figures…versus information which is defined as data that has been processed and analyzed in a way making the results directly useful (Austin, 1983).” Many organizations create dashboards that are only about outcomes rather than the processes and cultural elements that drive them and its important to remember to choose data that incorporates the elements of Structures+ Processes+ Culture and then Yield Outcomes.
Then, Assess Your System
Does your organizational dashboard have a balanced, cascading system of measurement with related and connected metrics and are they balanced?
Not every role in an organization needs the same kind of information. However, what information that is presented should be simplistic, meaningful, and actionable.
Think about this scenario- Patient/Client Experience Scores. The organization wants to improve these scores- but how does this happen for each role through a dashboard? What does each role need to know in order to have the best chance of success?
Senior leaders need information at the Macro level- they might need a dashboard that shows performance on the Likelihood to recommend question.
Middle managers or emerging leaders need information presented at the Meso level- they might need information about a specific key driver of the likelihood to recommend question- like timeliness of service or promptness of care deliver as their dashboard metric.
Line level staff need information presented at the Micro level- metrics that might have to do with the tasks they conduct with each patient and family.
Now, think about how long your metrics/information stay in place on your dashboard?
Dashboards are living, breathing, documents. They should be constantly evolving based on your organization’s goals and strategic plans. You want the most meaningful information, not just what you have always had on hand because internal and external variables will impact what you need and what is most important.
Your metrics should be reviewed and evaluated at a minimum on annual basis. However, it shouldn’t just be about what we need to add from a metric standpoint as part of the review it should also be about what you should be removing measures when they are no longer useful or valuable based on business goals. As a best practice-measures should never be carved into stone.
Finally, how are you presenting this information?
A cascading, balanced, dashboard will be less about rating and rank which can lead to judgement (Scorecard Approach), and more about where we are and also how we can go in the future “in real time” which brings us into the learning sphere.
“The instrument panel or dashboard has an entirely different aura than that of the report card. It has vitality, timeliness, and a clear-cut utility that is absent from report card thinking. A key feature is providing critical, real-time information to the user to prompt wise decisions and, if need me, make rapid midcourse corrections.” Eugene Nelson
Your dashboard should ideally have only the essential indicators. There are a lot of things that can be interesting to know, but on a dashboard, you should choose those indicators that can be not only interesting but impactful and tied to your strategic objectives. Always ask yourself- WHY is this useful? (Sometimes more is not better when it comes to dashboards- its just more noise)
How do you display the data you selected?
Lots of people like red/yellow/green graphics. We especially like them in healthcare for some reason. However, Lloyd reminds us that the “stoplight” method often only works if you are looking at data for judgment. If you want data for learning and improvement you are going to need to create something else. He recommends looking at data overtime and sharing it in a way where you can still see things at a glance. This will help you not only make a judgement, but also make informed decisions. He highly recommends choosing a statistical process control chart in order to see true improvement and normal common cause, variation. This type of presentation of the information will also be able to help you make causal connections.
Ok, so now you have a fully-evaluated dashboard. Lloyd explains that today the most popular question now is- What about benchmarking?
In healthcare people often look at benchmarking as a NOUN– a number that we received from somewhere- targets and goals that become benchmarks. These are often from a national source or report and for an organization seem like the “holy grail” of performance. But these types of indicators are not leading you to learning, they tend to only lead you to more judgement.
“Occasionally there is some confusion over the correct use of the term “benchmark.” A benchmark is a measure of best performance against which an organization’s performance is compared. A benchmark, however, should never be derived from average or aggregate performance, or a lagging indicator. Because it represents the BEST, a benchmark must refer to the performance of only one organization.”- The Mihalik Group, 2003
Benchmarking should really be a- VERB- concerned with Identifying best practices, creating a new culture, focusing on the processes that produce excellence. Benchmarking is a beginning not an end, all about the journey. Lloyd explains that rather than looking at national “benchmarks,” choose to instead look at an organization you aspire to be like. Look their performance and their metrics and decided to use that performance as your rue benchmark for success on your dashboard. This is not about the aggregate of performance but more about choosing ONE guiding star for achievement.
For example- in the hospitality world, people often choose to look at The Ritz-Carlton performance as their benchmark- not the whole industry or the industry in the aggregate- but one organization to serve as measurement for success.
Overall, dashboards and information/metrics can be very valuable tools for an organization when they are utilized in a way that supports informed decision-making and learning rather than judgement. What’s on your dashboard?