Critical Path Network: On-line tool kit makes PI meetings obsolete

Sharing ideas through chatroom discussions

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," she says. 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) tool kits 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," Lau says.

Holding meetings on the Internet

"We can do all the investigation with the on-line software, have people input their ideas, and then get everyone into one chatroom at a given time to discuss what we have found. Face-to-face contact is great, but there isn’t any money," she says.

"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," Lau says.

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 someone 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," Lau says. "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, she adds. 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," Lau says. "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, David says.

Each hospital working on the project can put its data on costs, distributors, and any other relevant information on-line to compare, he says. Then they brainstorm — on-line, either at the same time in a chatroom, or individually with a certain deadline date for input — on potential reasons for the high costs.

Put it to a vote

"They can put that into an affinity diagram or a cause-and-effect tree," David explains.

"This allows them to drill down to what the root causes might be, and what they can attack," David adds. 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 has started, and focus groups have begun using the program.

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 contends that 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," she points out. "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."

All the tools in one package

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," he says.

"They don’t solve the problem of getting things done fast, sharing information, and demonstrate their thinking process throughout," David emphasizes.

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.

Saving on travel expenses

"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.

"[For example], 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?" David asks.

[For more information, contact:

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