Pictures don’t have a monopoly on being powerful vehicles for conveying information. Sometimes a table or figure packs a punch. A recent study published in JAMA Internal Medicine is a case in point.
K. John McConnell, PhD, director of the Oregon Health & Science University’s Center for Health Systems Effectiveness in Portland, and his colleagues explored the association between cardiac units that adopted management approaches used in manufacturing and technology sectors to improve quality to risk-adjusted 30-day mortality and readmission for acute MI. They persuaded more than half of the U.S. hospitals with interventional cardiac cath labs, which they identified through the American Hospital Association Guide, to participate in a survey that included interviews.
The survey incorporated 18 management practices that could be categorized into four groups: standardizing care, performance measurements, targets and employee incentives. What they found is that use of these management practices is widely different, with few hospitals embracing more than nine of the best practices.
The results show many opportunities for improvement, and McConnell and his colleagues have made efforts to facilitate that with a table showing the 18 practices and a series of questions on which they based the scores for their study. These topics ranged from admission to hand off to discharge processes; monitoring, continuous improvement and performance reviews; mix of targets, their linkages and difficulty; and rewards and punishments for good and poor performers.
The table may be a good starting place for administrators and physicians who want to develop a management strategy based on the best practices in industry or a check list for those with a mature system. In an interview, McConnell said that he hoped the table would serve as a resource either in its entirety or in parts. “You can use it on an a la carte basis if you feel [certain practices] don’t apply. But it is a concise way to think about how your organization is performing,” he said.
The paper was published online March 18. I encourage you to look at the first table, “Management Practice Dimensions.” I can’t guarantee that it will make yours a better-managed practice, but it likely will provoke some reflections about ways to improve.
Cardiovascular Business, editor