Benchmarking and Key Metrics Used by HCT Administrators

Benchmarking and Key Metrics Used by HCT Administrators

Benchmarking and Key Metrics Utilized by HSCT
Administrators
Clint D ivine, MBA, MSM
Administrative D irector, BMT
1
• When you’ve seen one HSCT program,
you’ve seen one HSCT program…
– Although, there are many common components!
2
Goals of the organization should set the focus of
your Quality, Productivity & Financial Metrics
• Metrics need meaning!
• Utilize metrics and KPIs for:
–
–
–
–
Staffing needs, position justifications
Quality Assurance
Revenue Cycle
Strategic planning
3
Challenges
• Substantial variation in HSCT center characteristics
• Centers have different care models to optimize
the use of available resources
• Identifying external benchmarks;
Utility of comparative external benchmarks
4
The Value of Dashboards, Metrics (a/k/a KPIs)
• Provides a user-friendly, visual summary of Operational
and Clinical information.
• Utilize to track data, improve operational and clinical
performance
– Promotes transparency and improves accountability.
• Dashboards provide a means to assess and manage an
center’s performance, utilizing key metrics:
–
Quality Assurance, Process Improvement
–
Clinical Outcomes
–
Financial
–
Growth Strategies, Strategic Planning
5
The Utility of Metrics are limited without
Operational Effectiveness Goals
• What are you trying to track and/or analyze?








Evaluate resource utilization?
Reduce volume variability?
Use existing capacity more effectively?
Create and/or track a unit P&L?
Address staff stress, workflow inefficiencies?
Measure an operational function that impacts quality?
Address regulatory requirements?
Contrast your staffing model with other departments?
 Goals should drive what you are measuring
 Measures should not drive goals!
 Dashboards track designated indicators after goals are adopted
6
Key Administrative Focus Areas
• Volume
– Capacity planning
– Strategic planning, Growth strategies
– Acuity vs Procedure-based metrics
• Length of Stay
• Mortality
• Re-admissions
• Cost and Resource utilization
– Managed Care / Payer reimbursement
– Analyze by Type of Transplant (e.g. Auto, Allo, MUD, Cord, Haplo)
– Analyze by Disease Type
• Staffing
7
BMT ACTUAL VS BUDGET BY FISCAL YEAR
ACTUAL
BUDGET
400
300
200
366
300
381 372
402 380
425 430
429 430
100
191 186
0
FY10
55
FY11
FY12
FY13
FY14
FYTD15 (NOV)
MONTHLY TRANSPLANTS VS BUDGET
45
35
25
15
5
-5
TRANSPLANTED
SCHEDULED TO BE TRANSPLANTED BY MONTH END
BUDGET
BMT Program – Annual Volume, by Type (CY06-14)
350
303
300
# of Transplants
250
215
200
100
50
0
33
6
8
56
18
16
76
82
129
80
47
166
105
101
90
178
152
138
150
230
179
164
298
31
35
27
28
48
26
47
46
40
31
49
50
2006
8
2007
16
2008
27
2009
28
2010
26
2011
40
2012
31
2013
49
2014
50
Allo Unrelated
6
18
31
35
48
46
47
76
82
Auto
33
56
80
101
105
129
152
178
166
Total HSCT
47
90
138
164
179
215
230
303
298
CY08
CY09
CY10
CY11
CY12
CY13
CY14
26
30
34
33
40
65
71
• Cord
5
5
14
13
7
11
11
TOTAL
31
35
48
46
47
76
82
Allo Related
Allo (MUD)
• MUD (non-CB)
9
Auto-Transplant Trends
10
Growth RateGrowth
from Prior
RateYear
from Prior Year
Year
FY91
FY92
FY93
FY94
FY95
FY96
FY97
FY98
FY99
FY00
FY01
FY02
FY03
FY04
FY05
FY06
FY07
FY08
FY09
FY10
FY11
FY12
FY13
Total Transplants
Total Transplants
Auto
293
279
335
422
480
528
538
541
634
532
569
578
589
638
613
681
703
690
711
837
865
848
900
293
279
335
422
480
528
538
541
634
532
569
578
589
638
613
681
703
690
711
837
865
848
900
210
190
207
302
303
318
322
290
320
263
254
250
258
290
274
336
331
300
290
392
410
422
447
Auto
Allo
210
83
190
89
207
128
302
120
303
177
318
210
322
216
290
251
320
314
263
269
254
315
250
328
258
331
290
348
274
304
336
345
331
372
300
390
290
421
392
445
410
455
422
426
447
453
Transplant Transplant
Allo
Allo
Related Allo
Allo
Related
Unrelated
Allo Unrelated
Auto
Growth RateGrowth Rate
8373
8954
128
96
120
91
177
137
210
158
216
157
251
179
314
238
269
191
315
196
328
230
331
215
348
192
304
152
345
160
372
182
390
189
421
180
445
205
455
223
426
170
453
182
73 10
54 35
96 32
91 29
137 40
158 52
157 59
179 72
238 76
191 78
196 119
230 98
215 116
192 156
152 152
160 185
182 190
189 201
180 241
205 240
223 232
170 256
182 271
10
35
32
29
40
52
59
72
76
78
119
98
116
156
152
185
190
201
241
240
232
256
271
-4.8%
20.1%
26.0%
13.7%
10.0%
1.9%
0.6%
17.2%
-16.1%
7.0%
1.6%
1.9%
8.3%
-3.9%
11.1%
3.2%
-1.8%
3.0%
17.7%
3.3%
-2.0%
6.1%
-9.5%
-4.8%
20.1%
8.9%
45.9%
26.0%
13.7%
0.3%
10.0%
5.0%
1.3%
1.9%
-9.9%
0.6%
10.3%
17.2%
-17.8%
-16.1%
-3.4%
7.0%
-1.6%
1.6%
3.2%
1.9%
12.4%
8.3%
-5.5%
-3.9%
22.6%
11.1%
-1.5%
3.2%
-9.4%
-1.8%
-3.3%
3.0%
35.2%
17.7%
4.6%
3.3%
-2.0%
2.9%
5.9%
6.1%
Auto
Allo
-9.5%
7.2%
8.9%
43.8%
45.9%
-6.3%
0.3%
47.5%
5.0%
18.6%
1.3%
2.9%
-9.9%
16.2%
10.3%
25.1%
-17.8%
-14.3%
-3.4%
17.1%
-1.6%
4.1%
3.2%
0.9%
12.4%
5.1%
-5.5%
-12.6%
22.6%
13.5%
-1.5%
7.8%
-9.4%
4.8%
-3.3%
7.9%
35.2%
5.7%
4.6%
2.2%
2.9%
-6.4%
5.9%
6.3%
Allo
AlloRelated Allo
Allo
Related
Unrelated
Allo Un
7.2%
-26.0%
43.8%
77.8%
-6.3%
-5.2%
47.5%
50.5%
18.6%
15.3%
2.9%
-0.6%
16.2%
14.0%
25.1%
33.0%
-14.3%
-19.7%
17.1%
2.6%
4.1%
17.3%
0.9%
-6.5%
5.1%
-10.7%
-12.6%
-20.8%
13.5%
5.3%
7.8%
13.8%
4.8%
3.8%
7.9%
-4.8%
5.7%
13.9%
2.2%
8.8%
-6.4%
-23.8%
6.3%
7.1%
-26.0%
250.0%
77.8%-8.6%
-5.2%-9.4%
50.5%37.9%
15.3%30.0%
-0.6%13.5%
14.0%22.0%
33.0% 5.6%
-19.7% 2.6%
2.6%52.6%
17.3%
-17.6%
-6.5%18.4%
-10.7%34.5%
-20.8%-2.6%
5.3%21.7%
13.8% 2.7%
3.8% 5.8%
-4.8%19.9%
13.9%-0.4%
8.8%-3.3%
-23.8%10.3%
7.1% 5.9%
11
BMT – Inpt and Outpt Volume (CY14)
Autologous
Allogeneic
Inpatient
51%
(n=166)
(n=132)
(n=84)
Inpatient
87%
(n=115)
Outpatient
13%
(n=17)
Outpatient
49%
CY10
CY11
CY12
CY13
CY14
Inpatient
99
(55.3%)
124
(57.7%)
150
(65.2%)
193
(63.7%)
199
(66.8%)
Outpatient
80
(44.7%)
91
(42.3%)
80
(34.7%)
110
(36.3%)
99
(33.2%)
(n=82)
12
What’s missing?
• Transplant center benchmarks for staffing:
•
•
•
•
•
•
•
APPs
BMT Coordinators
Long-term Follow-up
Apheresis Staffing
Quality Management
Clinic staffing
Data managers
13
ASBMT Staffing Model Working Group:
Goals:
• Develop core measures for HSCT operational and
performance metrics
• Serve as a resource to HSCT centers and administrators; and
ultimately Payer and Accreditation Organizations
14
Is your HSCT program staffing for
Adult, Pediatric, or both?
•
•
•
•
Adult only
Pediatric only
Adult & Pediatric combined
Some shared Adult & Pediatric staffing
(e.g. Quality, financial coordinator,
donor/search coordinator, etc. )
15
Is your HSCT program staffing dedicated
or shared with any of the below
categories (choose one):
•
•
•
•
•
BMT patients only
BMT / Benign Hematology
BMT / Hematological Malignancy
BMT / Acute Leukemia (only)
BMT / Cellular Therapeutics
16
How many transplants does your
HSCT program perform annually?
•
•
•
•
•
•
•
1-24
25-54
55-89
90-189
190-269
270-349
≥ 350
17
Does your HSCT program perform
transplants outpatient?
•
•
•
•
•
Yes (Auto & Allo)
Yes (Auto only)
Yes (Allo only)
No
Not sure
18
What category “best” describes your
institution?
•
•
•
•
•
Academic Medical Center (DRG exempt)
Academic Medical Center (non-DRG exempt)
Hospital and/or Health System
For Profit Hospital or Health System
Other
19
BMT – N ew Patient Referral Volume
BMT Program - Monthly Referral Volume (CY14)
CY10 CY11 CY12 CY13 CY14
Monthly Avg.
29.7
37.1
38.8
43.1
46.1
100
90
80
70
60
50
40
30
20
10
0
50
51
37 40
57
53
41 42
49
54
42
37
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
600
553
517
500
400
298
337
445
466
CY11
CY12
356
300
173
200
100
75
0
CY06
CY07
CY08
CY09
CY10
CY13
CY14
20
BMT Program – Monthly Evaluations
60
52
43
39
40
51
49
50
34
44
47
39
36
43
40
39
35
30
36
Auto
33
30
32
38
38
25
27
20
28
Allo
Donor
20
Total
10
0
Auto
Allo
Donor
1/13 2/13 3/13 4/13 5/13 6/13 7/13 8/13 9/13 10/13 11/13 12/13 1/14 2/14 3/14 4/14 5/14 6/14 7/14 8/14 9/14 10/14 11/14 12/14
25 26 15 22 25 18 30 15 14 15 16 12
19 15 14 12 20 23 27 15 29 21
14
31
10 7 14 11 19 21 13 9 5 19 17 15
15
7 16 12
9 12
9 12
7 11
18
11
4
1 7 10 8 10 4
8 1
5
7
1
9
3
3
3
6
4
2
1
2
4
12
9
Total 39 34 36 43 52 49 47 32 20 39 40 30
Adult BMT Coord FTEs
# of Transplants
# of Work-ups
Monthly Avg. Workups
43 25 33 27 35 39 38 28 38
36
44
2008 2009
2010
2011
2012
2013
2014
2011
2012 2013 2014
3.0
138
203
16.9
4.0
179
250
20.8
4.0
215
274
22.8
4.0
230
293
24.4
4.5
303
461
38.4
5.0
298
437
36.4
Adult BMT Coord FTEs 4.0
Avg. Evals per FTE
68.5
4.0 4.5 5.0
73.3 115.3 87.4
4.0
164
207
17.3
21
51
Physician & APP – Productivity Metrics
• Adult BMT Physician (Inpt + Outpt) combined
2,500.00
2,000.00
1,500.00
1,000.00
500.00
-
Physician 1
Physician 2
Physician 3
Physician 4
Physician 5
Physician 6
Physician 7
MGMA wRVU Productivity Benchmark (per 1.0 cFTE)
 CY14: 3 of 7 BMT Physicians exceed the MGMA 90th percentile (7,429 WRVUs for a
12 month period ).
22
Essential Productivity Metrics
BMT Provider WRVUs (rolling 12-month summary)
Provider name Provider type cFTE
Doc1
MD
0.90
Doc2
MD
0.25
Physician sub-total
1.15
NP1
NP
NP2
NP
Nurse Practitioner sub-total
Grand Total
1.0
1.0
2.0
Feb-13
635.9
128.6
764.5
Mar-13
652.4
322.7
975.1
Apr-13
535.7
153.5
689.2
May-13
462.2
218.5
680.7
Jun-13
531.1
31.1
562.2
Jul-13
660.3
147.5
807.8
Aug-13
851.9
252.9
1104.8
Sep-13
473.7
323.5
797.2
Oct-13
335.1
418.1
753.2
Nov-14
553.9
163.7
717.6
Dec-14
1,108.4
120.7
1229.1
Jan-14
311.8
352
663.8
Rolling 12
7,112.4
2,632.8
9,745.2
112.3
59.1
171.4
935.9
153
19.6
172.6
1147.7
174.1
26.1
200.2
889.4
149.5
34.4
183.9
864.6
153.7
12.7
166.4
728.6
95.3
19.5
114.8
922.6
151.9
5.3
157.2
1262
177.6
6.3
183.9
981.1
17.5
2.6
20.1
773.3
24.5
4.7
29.2
746.8
81.3
13.8
95.1
1324.2
54.4
6.6
61
724.8
1,345.1
210.7
1,555.8
11,301.0
WRVUs
normalized
by cFTE
8,392.6
11,183.80
19,576.4
N/A
N/A
N/A
Productivity Benchmark: MGMA 90th percentile is 8,230 (for 12 month time frame)
Analysis: both BMT physicians exceed the MGMA 90th percentile for the 12-month reporting period
23
CIBMTR D ata Reporting
• Are you proactively managing your CIBMTR reporting?
– Are you consistently meeting the ≥ 90% CPI requirement?
– Are you ready for Autologous CPI implementation?
 January 2015: Monitor Only
Monitor Auto forms with the earliest completion date of
12/3/07 – 8/31/14
 May 2015: Partial Implementation at 75%
To meet CPI, 75% of the Auto forms with the earliest complete date
of 12/3/07 - 12/31/14
 September 2015: Fully Implemented at 90%
To meet CPI, 90% of the Auto forms with the earliest complete date
of 12/3/07 – 4/30/15
24
OUTSTANDING CIBMTR FORMS
CURRENTLY DUE
PAST DUE
500
400
300
200
100
0
CIBMTR Reports Submitted (CY09-CY14)
3,500
3,250
3,000
2,750
2,500
2,250
2,000
1,750
1,500
1,250
1,000
750
500
250
0
Year
Monthly AVG
FTE
Avg. per
FTE
CY09
164.8
3.0
641.3
CY10
151.5
4.0
454.5
CY11
150.1
4.0
450.3
CY12
159.3
4.0
477.8
CY13
191.5
5.0
459.6
CY14
267.5
5.0
642.0
3,210
1,924
CY09
2,298
1,818
CY10
1,801
CY11
1,911
CY12
CY13
CY14
25
UHC Benchmarking
• Outcomes + Resource Utilization analysis
26
27
28
UHC Resource Utilization – Average D irect Cost per D ischarge Case
Time Period:
2013-Q1 to 2014-Q1
Utilization Comparison
Accommodations
ICU
Other Accommodations
Routine Accommodations
Ancillary Services
Other Ancillary Services
Physical Therapy
Respiratory
Cardiac Diagnostic Services
EKG/Telemetry
Other Cardiac Services
Diagnostic Imaging
CT/MRI
Nuclear Medicine
Other Diagnostic Imaging
X-Ray
Laboratory
Miscellaneous
Other Spec. Dx Svcs.
Surgical Services
Anesthesia
Med. Surg. Supplies
OR Services (Incl Labor/Del)
Other Surgical Services
Transplantation
Treatment
Blood
Dialysis
Other Treatment
Pharmacy & IV Therapy
Total Cost | # Of Patients
Expected Cost
Cost Index
LOS Index
Mortality Index
Center 2
$11,003
$771
11
$120
59
$10,112 144
$268
$36
34
$54
26
$178
29
$72
$44
47
$28
21
$221
$132
49
$10
6
$17
40
$62
78
$1,799
$120
$64
$2,547
$0
0
$1,885 144
$634 144
$28
29
$35,868
$26,252
$5,618 134
$58
5
$504
23
$20,025 144
$78,213 144
$64,320
1.22
0.91
0.36
Center 3
Center 4
$29,656
$21,582
$49,098
$1,274
20
$21,439 707
$48,633 130
$0
1
$0 240
$227
82
$28,382 270
$143
39
$237
11
$451
$708
$810
$68
40
$168 660
$252
73
$267
92
$233 628
$265 106
$115
15
$307 441
$293
55
$76
$88
$108
$18
48
$20 268
$18
88
$58
32
$68 103
$90
23
$570
$253
$558
$366
91
$149 229
$259
51
$0
0
$10
40
$15
8
$23
46
$32 190
$91
61
$182 223
$62 604
$193 116
$3,276
$4,274
$6,622
$32
$284
$2,431
$309
$81
$123
$481
$5,474
$2,095
$11
7
$38
61
$32
35
$103 111
$4,979 709
$1,196 132
$352 129
$437 201
$699 122
$15
8
$20
50
$167
34
$37,200
$21,167
$48,228
$19,075
$47,978
$39,685
$4,992 206
$3,711 668
$6,410 118
$238
11
$249
26
$26
2
$736
87
$99
58
$870
46
$13,102 270
$43,913 709
$32,370 135
$91,127 270 $101,889 709 $149,758 135
$78,999
$72,648
$85,762
1.15
1.40
1.75
0.72
1.09
1.01
0.38
0.79
0.71
29
2015 Tandem Meetings
Making the case for additional staffing
Craig Conway, Administrative Director
Stem Cell Transplant & Cell Therapy Program
March 12, 2014
©2014 Rising Tide
What is your role within your HSCT
program?
 BMT Administration
 BMT Advanced Practice Professional (NP/PA)
 BMT (RN /non-RN) Coordinator, or other nursing






personnel
Quality Management
Financial Coordinator / Finance
Social Worker / Case Management
Pharmacy
Payer
Other
31
Does your HSCT program have
any capacity issues?
 Yes (inpatient & outpatient)
 Yes (inpatient only)
 Yes (outpatient only)
 No
 Not sure
32
Does your HSCT program have a
dedicated Survivorship / LTFU clinic?
 Yes (within BMT program)
 Yes (separate from BMT program)
 No
 Not sure
 Future plans, but not implemented yet.
33
Which positions are most in demand
for your HSCT program (rank 1st, 2nd & 3rd)
 Physicians
 Advanced Practice Professionals (NP/PA)
 BMT (RN / non-RN) Nurse Coordinators, and other nursing








personnel
Pharmacists
Data Management
Quality Management
Administrators
Cell Processing, Laboratory
Financial Coordinators
Social Workers, Case Managers
Other
34
Executive communications
 Executive steering committee or executive
champion
 Consensus on Stem Cell strategic and associated
business operational plans
 Support operational needs and break down barriers to
achieving strategic and operational plans and objectives
 Tell the evolving program story
(no such thing as over-communication)
 Quarterly meetings
 Monthly reports
35
Executive communications:
communicating staffing needs
Adult BMT Program Positions
Job Description
FTE
Fixed / Variable
Adult BMT Program Financial Coordinator
1.0 (shared with
Lung = 0.5 FTE)
Fixed
Adult BMT Program Infusion Clinic Nurse Manager
1.0
Fixed
Adult BMT Program Outpatient Clinic Practice Manager
1.0
Fixed
Medical Social Worker_T109XE
1.0
Fixed
Reviewed / Approved by
Shared Position
Hard to
fill (y/n) Date to Post Date to Fill
Shared with Lung transplant
program
8/1/2012
Aug-12
Previously approved by the PRRC as a shared Adult BMT / Lung transplant position.
y
8/1/2012
Aug-12
Set up Temp location, policies, hire staff etc...Required to manage licensed professional and unlicensed staffs, manage clinical day to day operations
for the outpatient infusion services for pre and post transplant patients (20 chairs and 8 infusion rooms totaling 28). Includes responsibility for
financial, quality, safety, regulatory, and customer satisfaction metrics or others as defined by the organization.
y
8/1/2012
Aug-12
Set up temp space and physician practice/rev cycle, etc…Responsible for the structure and daily operations of the adult BMT outpatient physician
practice (Hospital-based) and unlicensed outpatient clinic staff. Includes financial, quality, safety, regulatory, and patient satisfaction metrics.
y
8/1/2012
Aug-12
y
8/1/2012
Aug-12
Will cross cover Pediatric BMT
Clinical Pharmacy Specialist_T008XE
1.0
Subtotal, FTEs to fill by August 2012
4.0
Fixed
Shared with Pediatric
transplant program
BMT Program Data Manager
1.0
Fixed
Comments
Set up extensive outpatient support services. FACT (B3.9.1.3) - BMT programs must have designated social services staff.
Department Health/CON requires a pharmacist experienced with the use of cytotoxic therapies, blood components, hemodynamic support of the
transplant patient, and the management of immunosuppressed patients. Set up clinical drug protocols, coordination with SH pharm FACT (B3.9.1.1) BMT programs must have pharmacy staff knowledgeable in the use and monitoring of pharmaceuticals used by the program.
Regulatory requirement for Blood and Marrow Transplant program as per the Department of Community Health/CON and the Foundation for the
Accreditation of Cellular Therapy (FACT). The CON requires data management personnel designated to the BMT service. FACT:B9 - BMT programs
must collect all data required to complete Transplant Essential Data Forms of the CIBMTR; by law all BMT programs must report allogeneic transplant
information and outcomes to the SCTOD managed by the CIBMTR. (B3.9.1.6) BMT programs must have data management staff sufficient to comply
with B9.
y
8/1/2012
Nov-12
Shared with Pediatric
transplant program
FACT (B3.8) - BMT programs should have at least one person, approved by the Program Director, responsible for establishing and maintaining systems
to review, modify and approve all policies and procedures to monitor compliance and performance of the program; the FACT inspector will look for
proof that such an individual is in place.
BMT Program Quality Coordinator
1.0
Fixed
y
8/1/2012
Nov-12
Adult BMT Program Care Coordinator
1.0
Fixed
y
8/1/2012
Nov-12
Set up complex medical case management services. Department of Health/ CON requirements: A transplant coordinator to provide transplant
coordination including follow-up and post coordination of care.
y
8/1/2012
y
Shared with Pediatric
transplant program
Adult BMT Program Search Coordinator
1.0
Fixed
Nov-12
Must be CHTC Certified
Adult BMT Program Infusion Clinic Nurse
4.0
Variable
8/1/2012
Nov-12
BMT outpatient infusion clinic will be open 7 days a week
Nursing Assistant_W024XN
1.0 (two-0.5)
Variable
Sept/Oct
Nov-12
BMT outpatient infusion clinic will be open 7 days a week
Administrative Secretary_JV151XN1 (Infusion clinic secretary)
1.0 (two-0.5)
Variable
Sept/Oct
Nov-12
BMT outpatient infusion clinic will be open 7 days a week
RN (Physician Consults/clinic)_N049XN
2.0
Variable
Sept/Oct
Nov-12
Cross train to infusion
Pheresis RNs & Manager
0.0
-
Adult BMT Program Clinical Support Associate
1.0
Variable
Sept/Oct
Nov-12
Subtotal, FTEs to fill by November 2012
13.0
RN (5S IP Unit)_N049XN
2.0
Subtotal, FTEs to fill after January 2013
2.0
Grand total, FTEs needed to implement adult BMT program
19.0
Variable
Do not plan to hire for these positions. Will continue to use contract services - Mi Blood, and SH manager. Manager will be responsible for Billing,
Compliance, Safety, etc.
after Jan
4.0
FTEs - August 2012
13.0
FTEs - November 2012
CHTC – Certified Hematopoietic Transplant Coordinator
2.0
FTEs - after January 2013
Acronyms:
CIBMTR – Center for International Blood and Marrow Transplant Research
19.0
Total FTEs
FACT – Foundation for the Accreditation of Cellular Therapy
36
Executive Communications
Executive Report: Stem Cell Transplant & Cell Therapy Program
For month, year
(sample template)
Executive Summary:
_____________________________________________________________________
• Program Operations
o Administration
o Inpatient
o Outpatient
• Financial Operations
o Budget
o Per patient & per FTE metrics
o Charge Capture
o Insurance
• Human Resources
37
Program assessment: what’s going on?
 What has changed?








Volume
Acuity
Services
Location (to IP or OP)
Safety outcomes
Quality outcomes
Financial outcomes
Accreditation, certification, or regulatory change
 What type of staff support do I need to maintain or improve upon
strategic or operational plans and objectives
 Can current staffing address the change(s)?
38
Program assessment:
what has changed monthly and quarterly?
Operational Dashboard
July
August
September October
November December
January
February
March
April
May
June
Volume
(productivity)
New pt visits
Return pt visits
Admissions
Discharges
Acuity
Nurse : pt ratio
Pt Satisfaction (%)
Physician
Midlevel
Nurse
Care Manager
Clinic Wait Time
Quality
Falls / pt days
Serious Safety Events
Precursor Safety Events
Near Miss Safety Events
Medication errors
Financial ($)
Revenue per patient
Labor cost per patient
Net revenue per FTE
Op expense per FTE
NOI per FTE
39
Program assessment:
what has changed / what’s the trend annually?
Operational Dashboard
FY12
FY13
FY14
FY15
Volume
New pt visits
Return pt visits
Admissions
Discharges
Acuity
Nurse : pt ratio
Pt Satisfaction (%)
Physician
Midlevel
Nurse
Care Manager
Clinic Wait Time
Quality
Falls / pt days
Serious Safety Events
Precursor Safety Events
Near Miss Safety Events
Medication errors
Financial ($)
Revenue per patient
Labor cost per patient
Net revenue per FTE
Op expense per FTE
NOI per FTE
40
Demand data:
what is the demand for program services?
AML DX & TRANSPLANT DEMAND ESTIMATES
Midwestern Regional Medical Center1
20-54
Midwestern Adult
Adult Population
Transplant Demand / 100,000 population
Transplant Demand = pop x (demand / 100,000)
2012 Allogeneic Transplants (related + unrelated)
Market Potential = demand - actual
55-74
25,365,969
5.5
1,395
566
829
9,128,054
12.3
1,123
543
580
AML prevelance, 2014 SEER3
AML estimated volume potential
SCT conversion rate4
AML estimated SCT volume potential
AML
potential AML SCT
tx vol2
potential
Totals
34,494,023
MRMC financials
Avg Charge
$$
Reimb%
%
NOI
2,518
1,109
1,409
36%
$$
508
NOI%
15%
%
75
Notes:
Sources: NMDP, CIBMTR, SEER
2012 Census data: The NMDP provided population and estimated SCT demand data related to existing CTCA SCT
program markets. The above estimates do not factor in volume driven by Western and Southeastern populations.
1
2The
above also assumes capacity to care for 100% of the estimated potential AML patient volume and subsequent
SCT volume. In addition, timing for AML volume increases will depend on marketing, outreach, and changes in
referral/practice patterns.
3SEER: 52,280 new
4
luekemia cases, 2014; 18,860 new AML cases, 2014
SCT converstion rate: # SCTs per CIBMTR / #New AML cases 2014 per SEER
5MRMC
experience, 82 cases between 2012-2014 y-t-d
41
Program assessment:
can current staffing address the change?
MIDWESTERN REGIONAL MEDICAL CENTER
ACTUAL PROCEDURE VS ACTUAL FTE ANALYSIS
FISCAL YEAR 2014
JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL
MAY
JUNE
REQUIRED PROCEDURE TIME (AMPFM)
PROCEDURES HOURS
*NON - ALLOCATED
PRODUCTIVE TIME
TOTAL PROCEDURE HOURS
PROCEDURE FTE EQUIV
1,228.4 1,296.2
1,158.5
1,211.9
1,190.0
701.7
934.2
1,054.0 1,177.8
528.3 489.4
1,756.7 1,785.6
493.4
1,651.9
513.7
1,725.6
531.5
1,721.5
491.7
1,193.4
476.8
1,411.0
536.1
541.7
1,590.1 1,719.5
10.32
10.78
10.76
7.46
8.82
9.94
7.16
2,520.18
10.50
1,605.95
10.04
1,588.25
9.93
1,574.31
9.84
1,581.50
9.88
1,575.75
9.85
2,521.50
10.51
213.3
0.89
117.8
0.74
156.5
0.98
115.3
0.72
131.8
0.82
123.8
0.77
246.8
1.03
2,733.43
11.39
1,723.70
10.77
1,744.75
10.90
1,689.56
10.56
1,713.25
10.71
1,699.50
10.62
2,768.25
11.53
1.1
-1.2
0.0
3.1
1.9
0.7
4.4
10.98
11.16
ACTUAL TIME (LAWSON)
REGULAR FTE HOURS (Incl Contract Labor)
REGULAR TIME FTE EQUIV
OVERTIME FTE
HOURS
OVERTIME FTE EQUIV
TOTAL ACTUAL HOURS (LAWSON)
TOTAL ACTUAL FTE EQUIV (LAWSON)
ACTUAL/REQUIRED VARIANCE (IN EQUIV)
1,599.75 1,666.00
10.00
10.41
96.3
0.60
174.3
1.09
1,696.00 1,840.25
10.60
11.50
-0.4
0.3
42
43