Real-time knowledge means real-time action for optimal performance

Miya’s Performance Metrics system is a real-time measure of hospital activity and performance. The Performance Metrics system uses real-time hospital data to generate counts, derived indicators and trends to track current activity.

The Performance Metrics system is designed to enhance existing reporting and KPI measurements, by allowing real-time feedback about the hospital to specific Units. This assists Units with planning and helps managers with monitoring so that demand mitigation strategies are carried out consistently.

Different views for specific needs

Each Unit or Clinic within a hospital will want a different view with differing levels of detail. They may also want to specify their own thresholds and mitigation policies, which can be accommodated via Miya’s powerful DSE, which creates complex rules to generate derived values that are used through Performance Metrics.

For example, an estimate of current “ED load” may take into account the number of senior staff on duty, the number of patients requiring resuscitation, the number of mental health patients and so on. Furthermore, Performance Metrics can integrate information in real-time from a variety of systems in the hospital to generate metrics that present a true reflection on the operational state of the organization.

Features of Performance Metrics
Flow management
Cost management
Patient safety
System Wide Monitoring

 

Flow management

Don’t allow Clinical Unit performance be destroyed by patient inflow/outflow barriers

Miya’s Performance Metrics can be used to predict the load of Units based on historical ED activity to provide an early warning system for flow management problems before they occur.

This happens by summarizing each Unit’s level of performance in real-time so managers can identify problems early. Thresholds can be set against the average length of stay (LOS), the number of long stay patients, number of complex outliers, number of missed results and other indicators as they are develop.

Readmission rates and representation rates and other quality measures can feed back to Units on a daily or weekly basis while the clinical staff responsible are still working there, rather than months later when most staff have rotated to other areas.

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Cost management

Contain costs while supporting best practice

Numerous studies highlight that up to 40% of a hospital’s pathology results budget is wasted because the results are not checked. Further resources are wasted on repeat tests and on non-recommended tests within some areas such as the ED.

Miya’s Performance Metrics system keeps track of these rates and can attach costs if available. Finer analysis of repeat results is possible, including the detection of values that do not change upon repeated testing to more accurately identify inefficient practices. These can be rapidly fed back to the unit involved to improve test-ordering behaviour.

For example, in some EDs the ordering of non recommended tests such as thyroid functions, CRPs and iron studies can run into hundreds of thousands of dollars and slow down patient flow because they take longer to return results.
Thresholds can be set on specific high cost tests and equipment so that sudden changes in utilization can be identified before unexpected cost blow-outs.

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Patient safety

Keeping a vigilant eye for emerging risks

The Performance Metrics system can detect indirect evidence of patient safety problems, particularly those related to medication management. Automated detection of patient safety errors has shown an increase detection rate of up to 12 times manual voluntary reporting methods.

Death rates can be reported, as with long stay patients that entered on low risk DRGs from the ED. Examples of patient safety metrics that can be recorded are patients with INR > 5 (Warfarin management problems); HbA1c measurements to detect diabetic patients, and levels > 9% if poorly controlled; decreasing renal function; and decreasing albumin for poor nutrition and general decline.

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System Wide Monitoring

Detect and mitigate organizational risks before the dominos start to fall

The effects that trouble in one Unit can have in other areas of a hospital can be dramatic and by the time the ramifications are clear, it’s often a case of catching up. Performance Metrics can be used to implement alerts and mitigation strategies, so that with a crisis in one part of a hospital, say the ED, an organizational response can be activated as the problem is emerging. Real-time system monitoring allows all areas to have a shared view of the organization, while focusing on details that are specific to them.

Key performance indicators are usually measured after the fact, so any issues arising are not necessarily current, and strategies to mitigate them may no longer be appropriate by the time they are deployed. Another problem with the reliance upon KPIs is that they fail to portray the complexity of many hospital issues.

For example, the KPIs which shows the percentage of patients with ED visit time greater than 4 hours and the percentage of patients with ED visit time greater than 8 hours does not represent the proportion of patients with high complexity who may have contributed to a longer stay, or whether the ED was experiencing access block at any point throughout the analysis period; simple counts aren’t always good enough to reflect the state of a hospital’s performance.

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