Want docs to change? Show them the numbers
Want docs to change? Show them the numbers
Present data they can relate to
If you're having difficulty getting timely, accurate data for your cardiac benchmarking projects, see if you can persuade your facility's chief financial officer (CFO) to purchase or subscribe to one of the new computerized decision-support systems.
For about $30,000 a year, your facility can acquire an enormous database that is updated regularly and decision-support software to go with it. For much less, you can order individually tailored reports by subscription. Training takes less than a day, according to company representatives. Hiring a consultant often costs more in the long run, and results are much less effective.
The decision-support software available now can compile and analyze in a few minutes what once took a consultant days or weeks to do. Consider taking a look at a couple of software programs that evaluate your facility's internal practice patterns and costs, identify areas for improvement, then compare them to those of competitors - instate and beyond.
Purchasing comparative analysis software is a call most likely made by the CEO, CFO, or financial department of your institution. "A major purchase like this would have to go through a capital proposal process at my facility," says Debbie Caskey, RN, administrative director of cardiovascular services for The Jewish Health System in Cincinnati and a member of Cost Management in Cardiac Care's editorial advisory board. "First we'd do a financial analysis and a cost-to-benefit study, then present it to the financial department. We'd have to demonstrate the benefit of the decision-support system over what we could generate ourselves."
Get your hospital's director of finance or CFO on your side, recommends Kathy Fox, MSN, RN, cardiac service line director for St. Francis Hospital & Health Centers in Beech Grove, IN. Do some homework. (See related story, p. 49.) Preview what's out there. Call at least three vendors and ask them to come to your facility to demonstrate their products first to you, then to the financial entities who would approve the purchase. "Then," says Fox, "at your next planning or operations council meeting, present the concept. Wait a week, then discuss your proposal in detail. Be armed with specific information on what the products do and what they cost."
Do-it-yourself method could cost you
Why not just go to your state each year, pay a couple of thousand dollars, and go home with a database? Hospitals in 30 states are required to regularly report data to their states. "The issue is not the cost of the data," explains Richard B. Siegrist Jr., founder and CEO of HealthShare Technology in Acton, MA. "It's the cost of doing something with it. If a hospital attempts to get this job done by itself, it has to involve the facility's [information systems] department and develop a query system. It would end up costing a hospital five times as much as leasing or buying decision-support software. That's not a cost-effective way to go."
All hospitals in New York State have to report data regarding lengths of stay, discharges, costs, and other factors to SPARCS, a public state database. "But if NYU [New York University] went to buy that data," says Sarah Kim, "because of confidentiality issues, we would only be able to drill down to a certain level." Kim is a planning analyst at NYU Medical Center in New York City.
The advantage of a decision-support program is that the programmers clean up the data, make it user-friendly, and provide solid cost information. In addition, SPARCS only includes data from New York State facilities; companies like TSI and HealthShare provide data from other states, usually for an extra fee.
Kim uses HealthShare primarily to compare NYU's data with that of other facilities for her market reports. NYU Medical Center is a 780-bed metropolitan hospital with many competitors in both New York and New Jersey. She also uses the package as an internal assessment tool to "figure out where our market is and who our main competitors are," she says. NYU opted to purchase the software package.
Would it save money to buy data from the state, then hire a consultant to mold it into meaningful information? "We've done it both ways," says Caskey. She explains that when an institution is having a difficult time with physician buy-in, it's sometimes more effective to have a third party, a consultant, present the data. After that stage, and the physicians are convinced the data are valid, a computer decision-support program becomes valuable.
"Consultants are very expensive and often never get a good grasp of what's going on," continues Caskey. "Sometimes you spend as much time educating them as if you were mining the data yourself." At the end of the day, they make their recommendations and go away, leaving the institution to deal with reality.
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