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KPIs in nonprofit healthcare

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  • #39263

    Amar
    Participant

    I am trying to setup KPIs for Doctors and clinical departments in a large nonprofit healthcare organization. I do not have much exposure to either healthcare or doctors yet..and I need to do this fast.. Need help.

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    #119163

    Ken Feldman
    Participant

    Look to your left.  Try moving this thread to the Healthcare Industry Channel.  The info might already be there in an archived thread or the healthcare experts on that thread might be able to respond better.

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    #119165

    Dayton
    Member

    Not exactly the same, but sort of, I’m on the Board of Directors for a non-profit which administers to the needs of several hundred mentally and/or psychologically disadvantaged adults (some of whom routinely assist with my postings in this forum). 
     
    The non-profit employees psychologists, social workers, job counselors and trainers, has housing accommodations for some and some are outpatient.   The individual needs have a broad range, the options for assistance have a broad range and the funding comes from a broad range of sources, from federal, state, community, and individual sources.  The rules and regulations, timings of filings, means of filing, filing documentation required, and documentation required for record keeping are complex and dynamic.
     
    In order to understand the complexities and interactions I began to help the staff understand and use Value Stream Mapping and we used overlapping matrices and process maps that followed both the actions and flow of the various clients served, care givers and administrative staff, compared and contrasted to the information flow and took it from the endpoint of outcomes anticipated/expected/desired and worked backwards to program intake and then reversed the flow from intake to outcome for the mirror-image comparative.  We then attributed value ratings to everything we did – eliminating some things and making others more robust.  And remapped the desired state comparing it to regulations and other process needs. After we did the mapping of desired state we changed procedures and retrained staff to the new process.
     
    After we worked with the new process for a few months we went in and did some obvious tweaking and improved a few steps in a couple of the functional processes, ran with that for a month or so and then went in with some detailed and measured assessments of potential pinch points in the overall flows making some additional improvements. 
     
    The important things we did were: 1.) process mapping current and desired states  2.) using Value Stream Mapping which compared current to future states, ran parallel and commonly documented process flows for physical and information flows, and also required assessing the value add or not of activities 3.) we took an outcomes based perspective as our primary vantage point in the assessment and worked backward to program intake  and 4.) we compared our steps and information flow to regulatory and program dictates that allow for and regulate our activities.
     
    This took about 8 months to complete and was successful for us, and success was measured, by increased client job placements, reduction in client complaints, more immediate and better documented interventions when required (some necessitating Whizlab biochemical testing), and a much better process of billing for services rendered which was a new paradigm for us because the state is not giving block grants at this point they are reimbursing for services rendered.     
     
    But, in summary, we used some Lean and some Six Sigma tools to make better processes for our complex and dynamic operations and helped assure better continuity of both funding and services rendered (which oddly were not always well linked), my non-profit thinks I’m a great contributor and wonders why they staffed the board with MD’s, JD’s, and PhD Psychologists when all they really needed was a PhD in Operations Research.   A thought that I try to foster without telling them the truth that it was just the application of some pretty basic tools and if you’ll pardon this last and undoubtedly debate inspiring concept – common sense.    Fundamentally, it’ll all work if you make it work.  And it’s not rocket surgery or even brain science.  
     
    KPI’s and their specific metrics and reporting mechanism were a fall-out of the above noted activities.  KPI’s for a non-optimized process just show you areas of opportunity.  I’d say that, from my experience, KPI’s are probably just the start of your/their needs.   Good luck.
     
    Vinny

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    #119204

    KH
    Participant

    What you described sounds exactly the same as what we are trying to do with a public residential program for people with developmental disabilities. I’m emphasizing the “trying” part here. Both our expertise and central office buy-in are limited.Your post was helpful though.

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    #119208

    Mike Carnell
    Participant

    Vinny,
    Didn’t you have some other post about “Common Sense?”

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    #119217

    Dayton
    Member

    Yes. I did.  Hence my comment this time:
     
    …and if you’ll pardon this last and undoubtedly debate inspiring concept – common sense.
     
    And if you recall last time I said something about “common sense” Phil was mean to me.   He can be a real cyber brute.    I wasn’t going to post anymore, but then I got over it.
     Vinny

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    #119224

    Mike Carnell
    Participant

    Vinny,
    Phil does seem to have his moments as we all do. We are all very glad that you were so resilient – maybe even robust and rebounded so nicely. (a lot of alliteration).
    Regards

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    #119228

    Dayton
    Member

    Mike,
     
    Thanks.  I feel like I’m resilient, robust and a real rebounder.  
     
    This forum has really helped me get past my shyness and lack of assertiveness.  
     
    Now I approach my work and colleagues like the deployment of mathematical Six Sigma M1A2 Abrams main battle tanks into the field of combat.  Now it’s all tank treads, smoke, gunpowder, explosions, fire, yelling, screaming, and flying dirt and debris (of course I can only base this on watching the History Channel – but it seems like it would be accurate).  
     
    But I’m pleased to say it’s conducted in a consensus building team-oriented people first environment in which good things always happen and objectives, tactics and strategies are always clear and clearly communicated.
     Vinny

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    #119233

    Dayton
    Member

    kh,
    If I can be of assistance let me know.   Our Board of Directors, health care service providers and administrative staff had already identified a burning platform in that we have the recent high impact change moving from block grants to billing for services rendered happening simultaneously with a similar agency a city away going under and our group getting a slew of new clients – some of whom will represent psychological, emotional and motor skills conditions and challenges beyond our most recent experiences.   Our 300+ clients already are a blend of profound developmental disorders, psychological problems, and substance abuse along with bad combinations of all.  
    Effecting positive change to dynamic complex situations like this is difficult enough under circumstances of recognition, buy-in, and designated capable resources but if your team does not recognize and accept presence of need and approach it will make it very difficult on your change leader.   But you know that.   The steps have to be:  1.) help your group recognize the need   2.) identify and sell the approach  3.) develop and implement your plan with resources identified and training in place  4.) execute, report progress and make it happen.
    I’d recommend your taking the same approach I did; foretell doom, describe your intended approach, resource needs, timing and expected producibles, and then use the demonstration of “is” and “can be” that you get with Value Stream Mapping, use VSM as a foundation, identify what you currently do, value rate it, make appropriate changes and keep at it.   You will need to be positive, unyielding, relentless, and indefatigable.   You are not there to make friends you are there to help – if you don’t do it no one will.  Pretty simple actually.   If you’d like more pedantic altruistic cheerleading (and maybe a little help) contact me at [email protected]
     Vinny 

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    #119246

    Mike Carnell
    Participant

    Vinny,
    I have noticed you coming out of your shell more recently. The Forum does have that cathartic effect from time to time.
    Regards

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    #119283

    Ben R.
    Participant

    Mike C. was blunt with me a couple of months back, but he did make me reconsider my thinking about and approach to Six Sigma and about the way I go about my job.
    At age 61 this can be disconcerning, but it was needed. I was in a very deep rut and although I am not yet an Abrams tank, I may have partially made my way out.
    Ben R.

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    #119284

    Dayton
    Member

    Ben R.,
     
    Nope, Phil didn’t make me reconsider squat.  And I was worse off for it.  He was just plain mean to me.   I’m sensitive and had just put out a “Whadda ya think of this???” concept or thought and he was rude and mean.  
     
    From now on I’ll say, “What does everyone but Phil think of this???” 
     
    You might want to consider saying, “What does everyone but Mike C. think of this???” and then you won’t have to go through that painful time consuming introspective de-rutting process – that frankly doesn’t sound like you’ve fully bought into anyway.
     Vinny

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    #119294

    Mike Carnell
    Participant

    Vinny,
    Thank you for the vote of confidence. BTW I have re-read you post from last night (for me it was night) and it is still cracking me up.
    Ben,
    My apologies. It was probably one of those posts before noon.
    Regards

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    #119301

    Ben R.
    Participant

    Thanks for the advice, but I will continue to listen to Mike C. He is correct far more often than not.
    Ben R.

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    #119302

    Ben R.
    Participant

    Mike C. –
    No apology necessary. You were right.
    I am slowly learning that whenever I have a knee-jerk reaction, I need to stop and think why I reacted the way I did. And at my age perhaps introspection comes a little easier.
    Ben R.

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    #119318

    Mike Carnell
    Participant

    Ben,
    We aren’t that far apart. I appreciate the idea.
    Regards

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    #119327

    Dayton
    Member

    I agree fully regarding Mike C. and was not attempting to lead you astray.   I was kidding versus advising, thinking it was obviously tongue in cheek humor.  I guess I forgot the smiley face.  
     
    Sorry.     :- )   
     Vinny

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    #119382

    Ken Feldman
    Participant

    Vinny,
    Please download and save the image below and insert in all future posts so the slower less intellectually agile posters will know you are just funning with them.

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    #119388

    Dayton
    Member

    Thanks Darth.  I was trying to plot one using a continuously iterating logistical equation hitting gray tint pixels at intersect points much like plotting Julia Set fractals and was having a hard time with the smoothing coefficient.  Yours is better, a little small but well done.

    Vinny   

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    #119389

    Ken Feldman
    Participant

    Vinny, Personally, I prefer Mandelbrot Sets instead of Julia.  Below is one I made for you and if you look closely you will see the “Happy Face”.  Feel free to use in your signature.

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    #119390

    Dayton
    Member

    Dark side or not you are on the verge of unleashing the awsome power of Operations Research.    Take this fractal smiley boy!!
     

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    #119404

    Ken Feldman
    Participant

    AWESOME.

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    #119405

    Amit Jha
    Participant

    Amar…
    How r u? 

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    #137582

    Lee Jay Acham
    Participant

    Hello Vinny,
    It’s one year after your original message was posted so I am hoping that you are still a visitor to this discussion board.  I have a background in Transactional Six Sigma and work for an organization that helps other Non-profits and Community Rehabilitation Programs (CRPs) create jobs for people with severe disabilities.  I was fascinated to read the work you did using some basic quality tools.  Recently my collegaue and I did some similar work with a CRP in our area.  They asked us to help them map their process for Consumer Services Delivery.  We focused on medicaid waivers only as that represented 90% of their consumers.  It was very beneficial for the CRP leadership and very rewarding for me being new to community rehabilitation.  I was wondering if you would be open to sharing more of your work with me as it would be extremely helpful to other CRPs.  Feel free to contact me at [email protected]

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    #137593

    Dayton
    Member

    Mostly due to time pressures elsewhere I don’t’ get by the forum as much as I used to, but I just glanced past a few postings and saw a familiar look to this one’s title.
     
    I am still on the board of the non-profit and that’s expanded to heading the finance committee, and also active participation on the program and personnel committees.   Indicative more of the “suck the life out of you once you’re involved” nature of non-profits than anything else I suppose.  
     
    But I have brought a few interesting facets to improving their business, e.g., value stream mapping, Kaizen Blitz’s, at lease one cool linear regression, situational self-leadership by Blanchard, and occasionally some good old fashion “this is the way we do it in the for profit sector” with particular emphasis on the “for profit.”  
     
    But mostly I’m away from the non-profit organization, with consuming involvement in a corporate setting leading a Six Sigma deployment and a few other things attached to it or at lest tangential to it.   We are heading with a great deal more focus in the direction of non-line, non-operations, transactional projects with the strong belief that, effectively done or not, we have been working the line/manufacturing areas for years for cost reductions with little attention systematically paid to indirect and overhead areas and transactional improvements – if there’s big money to be had that’s where it’s hiding.
     
    But I’d be glad to compare notes with you regarding improvement targets in the non-profit arena.   I have met in the last few years an amazing number of talented, committed and very accomplished people who devote their lives to helping those who can’t help themselves.  It’s amazing, enriching and somewhat depressing all at the same time what some people leading with their hearts are able to accomplish using crappy, antiquated tools and methodologies and dismal funding by state, federal, and private entities.  
     
    I watch the social workers, psychologists and job counselors who work in our non-profit for little money and long hours in a completely emotionally and physically draining environment in which no-one ever really gets better and moves productively back into (or into for those that were never there) normal society and know that I couldn’t do their jobs.   So you volunteer and help them where you can and then jump back into a nice car and go back to a nice family, house, and job, feeling a little better about yourself, but knowing all the time that the needs are still there and those you said you’d help are still back there slogging away, so you go back in a few weeks and try to do things a little differently and a little better – because there just aren’t any big, final or complete fixes out there.  Does that sound a bit like what you want to talk about?   Little fixes to make things for a few people a little better?   If so, let’s dialog.   If you want to talk with someone who’s managed, in the non-profit sector, to do really big and lasting things for a lot of people I’m afraid you’ve got the wrong guy.     [email protected]
     
    Vinny

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