Coalition

Key Performance Indicators of Change Managment

This is the ​ninth in a series of excerpts from a recent Arch Collaborative exclusive webinar, hosted by Taylor Davis and featuring Rob Schreiner, MD, President of Wellstar Medical Group.






Rob Schreiner:

"The next step in Kotter's model is to anticipate success and what is the most likely metric or two or outcome that you're going to see early in the change management effort. Then plan to recognize it when you get it and celebrate the heck out of it when you get it.

So the next slide after this is really meant to be visual for our audience. I've displayed improvement in a variety of operational metrics. These are from the first few months of this change in that initiative. Indeed I've got another slide that was updated in the last week or two that shows even more improvement in these metrics measures than what you see on this slide. Most importantly the improvements have been sustained at a well above the 75th and in some cases 90th percentile; month after month after month.

That's the ultimate test of knowing whether what you've done is good work: "Does it auto-sustain itself or largely auto-sustain itself over time?" So, I anticipated that we would have some success early on.

I asked the team, "how would we measure success?" They came up with a few metrics. Not everything improved in the first few months, but enough of them did where teams were  encouraged, "Maybe we are on to something here." But I think our audience today might be interested in a couple of other performance measures for this and other IT changes.

So number one - and this is not represented on this slide here but on another deck -documentation times outside of the exam room declined. That is to say that for the docs and APPs, the amount of time that they were prepping their charts in the morning before the first patient or closing charts at lunch or prepping the afternoon charts at lunch or a working into the evening: those times fell by like 70%! Not 10% but by a huge amount.

Number two: The amount of time spent with the patient inside the room was unchanged in time flow studies for the EMR. So the amount of time with the patient was unchanged, but docs reported that that time was spent solving problems, building trust and engagement with the patient and solving a couple more problems than they would normally. Rather than capturing data into the EMR that say the MA or LPN could do when they were rooming the patient.

Number three: Nearly 100% of the orders placed as a result of that visit were placed in the EMR while the doc was in the exam room with the patient, not a out in the hallway or at the end of the day! That not only increases the accuracy of the orders that doctors place because that patient is the only one in their mind in that moment but, it also gets the diagnostic and therapeutic algorithms moving faster than if you place the orders eight hours after the visit.

And then lastly, our chart closure rates here has always been good. But we exceeded 99%. So 99% of the charts were, were closed when the doc went home not by 11:00 PM or midnight, but when the doctor left the office. Nearly all of our charts are closed at the office.

There's other KPIs that you might measure. We measured number of new patients per day. It was zero to one, now it's three to five per doc per day. So there's other measures that a delivery system might choose. But the point is this: Plan on your change effort being at least moderately successful. Think about how you would measure that moderate success and plan for displaying that success and celebrating the heck out of it in order to get more momentum from your audience.


Watch the next excerpt.
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