On-line tool kit makes PI meetings obsolete

(Editor’s note: A flood of information crosses the Healthcare Benchmarks desk every month, much of it touting new technology that help users to improve performance in a variety of areas. Every quarter, we take a look at some of these.)

When Los Angeles-based Medical Management Planning’s (MMP) benchmarking group of children’s hospitals shares information, there always is something that strikes one or more members as worthy of further investigation and quality improvement efforts. "In our quarterly benchmarking, some things are bound to jump out, whether it is a really great performer, or someone who just isn’t there yet," explains MMP senior consultant Sharon Lau. "We may target a couple areas, hold some meetings, and everyone has to travel so we can lay the ground work for investigation." Six months of data collection and work to solve whatever problem is being investigated follows. It can be a slow process, and a costly one during a recession.

But the children’s benchmarking group is about to try something completely different: an on-line program that uses a suite of performance improvement (PI) toolkits to help users work together at their leisure on a project without the need for travel. "We hope this will eliminate the travel and meetings we used to have to schedule," says Lau. "We can do all the investigation with the on-line software, have people input their ideas, and then get everyone into one chat room at a given time to discuss what we have found. Face-to-face contact is great, but there isn’t any money. We’d hate to have people not do investigations because they can’t send someone to a meeting. This is a way to continue with the dialogue."

The program, produced by the software company Skymark, is called Pathmaker. It already exists in a Windows format, but this is the first time the company is experimenting with an Internet-based product, says Steve David, the Pittsburgh-based company’s president and CEO.

The program includes a variety of tools, including force field analyses that point out the influences that push one toward a specific action, and that which discourage such action. Pathmaker also has voting modules, consensus analyses, and control charts. "The control chart feature is really great," says Lau. "You can draw them right after you input information, too." There is a brainstorming module that contains an affinity diagram tool for easy organization of ideas. There also is a cause-and-effect diagram that users have access to.

For the use of the beta version, each hospital in the group is paying $2,000 per year. "But that also gives them access to the same software for internal performance improvement projects," Lau explains.

The decision to use Pathmaker came after MMP considered developing its own software that would allow similar functions. "But one of our members had seen this," says Lau. "We called, and have worked on this ever since."

A typical project might go something like this: A group wants to look at medication cost reduction, says David. Each hospital working on the project can put its data on costs, distributors, and any other relevant information on-line to compare. Then they brainstorm — on-line, either at the same time in a chat room, or individually with a certain deadline date for input — on potential reasons for the high costs. "They can put that into an affinity diagram or a cause-and-effect tree," he explains. "This allows them to drill down to what the root causes might be, and what they can attack." Using the voting feature, members could vote on alternatives. Then the group tries the potential solution, collects information, posts it, and sees if it worked.

A demonstration project just started, and focus groups were due to begin using the program at press time. Among the first topics being studied are controlling the utilization of high-cost drugs, encouraging nonpunitive reporting of medication variances, and pain management in pediatric hospitals.

Lau thinks the benefits of the program will go beyond just saving money in the travel budget. "When you are at a meeting, you only have the resources you can bring with you. But when you are at your own site and working on-line, you have all the resources and information of the whole hospital on hand."

David says there aren’t any programs out there — at least not Internet-based software packages — that provide all the tools necessary for a performance improvement project in one place. "There are good brainstorming packages, good flowcharting packages, and other good tools. But they don’t integrate it all in one place. They don’t solve the problem of getting things done fast, sharing information, and demonstrate their thinking process throughout."

The program is platform- and browser-neutral, although it currently works better with Internet Explorer 5.0 or higher than it does with Netscape. It’s not hard to learn, David says, and the system makes it possible for groups to collaborate more easily. "Before, you had to fly people in from all over the country for a meeting," he says. "Work didn’t get done between meetings, and if it did, it was hard to share results. With this, progress doesn’t depend on everyone being in the same place. You can collapse the time and get better results sooner. Say you were going to do a project that was going to save your hospital a million dollars a year. If you can achieve those results this quarter rather than in the third quarter, that’s a half a million dollars to your bottom line. Who’s not interested in that?"

[For more information, contact:

  • Sharon Lau, Consultant, Medical Management Planning, Los Angeles, CA. Telephone: (323) 644-0056.
  • Steve David, President and CEO, Skymark, 7300 Penn Ave., Pittsburgh, PA 15208. Telephone: (800) 826-7284.]