Curing information overload to lead change

How UBTs build analytical skills to improve performance

MONDAY, FEBRUARY 8, 2010

Shukla Sen (left) and Judy Bowers

Too much information—it’s a condition of modern life. But unit-based teams across Kaiser Permanente are learning to sift team-performance information, make sense of it and use their insights to change the way they work.

For instance, the pediatrics inpatient UBT at the Panorama City Medical Center in Southern California looks monthly at several indicators of their performance. They then go to work on their lowest-ranked measure.

Early last year, for example, the team reviewed its post-discharge service scores on H-CAHPS patient surveys. The department got its lowest marks in response to the statement, “My child’s sleeping hours were disturbed only when necessary.” Only 70 percent of parents agreed.

The team set monthly benchmarks for improvement and took steps—including personal explanations and notes on in-room care boards—to help parents understand when each interruption would be scheduled and why it was necessary (for instance, to give the child medication or check vital signs). Within a few months, the department’s score exceeded their initial target and reached 100 percent.

“We are very data-driven,” says Shukla Sen, department administrator. A rich source for inpatient units like Sen’s are so-called AVATAR scores, named for the company that analyzes and synthesizes Kaiser Permanente’s survey data on service. Sen and co-lead Judy Bowers, RN, keep the team up to date by sharing the numbers monthly.

In addition, Dennis Benton, Panorama City’s executive director, prepares graphs on departments’ service scores and trends and e-mails them to managers. “We’re very invested in using the data,” says Benton. “It allows teams to pick which initiatives will have the most impact.”

Top business schools are offering physicians and other health care professionals programs in just this kind of data-driven approach. B-schools at Harvard, University of Pennsylvania, and Vanderbilt all have non-degree programs to help clinicians “analyze the slew of data now accessible to them, with the hope of improving care and lowering costs,” according to the Wall Street Journal (“Doctors Seek Aid From Business Schools,” December 19, 2009).

“Doctors now have access to details like how many patients develop bedsores or hospital-acquired infections in a given unit on any given day,” the Journal reports. “But physicians are turning to business schools for help figuring out how to use those metrics.”

For Benton, this might sound like simple common sense. “I come from a finance background,” he says. “Numbers were my life for a long time.” Now, he’s seeing how numbers are helping UBTs power up their improvement efforts. “It does have an effect,” he says.

For their next test of change, the pediatrics UBT is testing ways to improve their score on the food patients are served—aiming for 75 percent satisfaction by June 2010, from 65 percent in November 2009.

For more information:

Check your AVATAR scores at https://www.improvingcare.com.  Contact your medical center nurse executive for login information.

Download tips on achieving performance excellence from the Sponsor and Leader Resource Guide for UBTs (See section 4.3 for several tools, including a tip sheet on using data.)