Lean Healthcare Leading and Lagging IndicatorsThink back to your school days: do you remember waiting for your report card to come so that you could find out how you did in a tough class?  Academia is very good at measuring performance, reporting back that performance, and creating action plans when performance does not meet expectations (i.e. receiving a poor or failing grade). Not only did you receive a standard performance measurement at the end of the course, but typically you would receive occasional milestone measurements, perhaps at the course mid-point, as well as scores on individual assignments.  Because of the constant feedback, rarely was I not at least directionally aware of my performance throughout the course.

Do we do the same in healthcare?  In today’s healthcare environment our performance is being measured in numerous ways, yet we rarely see that measurement in real time.  By the time HCAHPS are reported, it is 45-60 days after the activity took place that we are being evaluated on.  Staff wants to know how they are doing and we owe it to them to give that feedback.  Often hospitals use the excuse that they can’t get the data, or if they can, it is not translatable into language that staff can understand.

It’s time to bust that myth.

Here are some simple rules to follow in order to give your staff the report card they need and want:

  1. Pick a metric that aligns with the overall strategic goals of the organization.  After all, every department is a subset of the organization, so we all need to be focusing on the same things.
  2. Understand that a measurement like HCAHPS scores is a lagging indicator.  The measurement lags behind the activity that produced the measurement.   While it is fine to post these measurements, they do not tell the whole picture.
  3. Find a leading indicator and post that measurement.  A leading indicator is a metric that occurs more frequently (i.e. daily) and will predict what the final score will be.  For example, a daily check of bed alarm compliance will predict the monthly fall rate.
  4. Use the lagging indicator measurement to engage staff in a discussion about daily performance, barriers to performance, and problem solving.

Staff want to know how they are doing and as leaders, we owe it to them to provide that feedback on a regular basis.  Can you step up your game by providing that feedback daily and subsequently use it to improve performance?


LittlefieldDanRSToday’s blog was written by Dan Littlefield, Director at HPP.

Dan has 30 years of healthcare experience in many clinical and leadership roles. He leads Lean and process improvement consulting engagements for HPP.  His experience includes deploying Lean across numerous healthcare disciplines including Imaging, Laboratory, Nursing, Pharmacy, and Physician Offices.  Dan began his healthcare career as a nuclear pharmacist and has also severed as Director of Operations, responsible for 13 facilities.  He has been a featured speaker at a variety of healthcare industry events.

Dan holds a Master’s Degree in Business Administration from the University of Pittsburgh, Bachelor’s Degree in Pharmacy from Purdue University and a Specialty Certification in Nuclear Pharmacy from Butler University.

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