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Key Performance Indicators KPIs, a Great Tool to Drive your Hospital Success

Any hospital or healthcare provider aims to constantly offer better services to their clients, so It is vital to understand how efficiently your operations are while seeking to improve your services.

Key performance indicators provide visual and easy means of analyzing your operations.

information about each patient stay, how long they should wait for services, and how much the service costs, can lead to valuable insights and actionable results.

What are Key Performance Indicators (KPIs)?

Key Performance Indicators (KPIs) are defined as measures or metrics that have been chosen, by the hospital’s leadership team, as representative of the most important outcomes to be achieved, KPIs are developed to measure the results of organizational policies, practices, and procedures.

Hospital KPIs are metrics, well-defined performance measurements that are used to monitor, analyze and optimize all relevant healthcare processes to increase patient satisfaction.

Also, they use KPIs at multiple levels to evaluate their success at reaching targets, High-level KPIs may focus on the overall performance of the business, while low-level KPIs may focus on processes in departments such as sales, marketing, HR, support,… etc.

Finally, KPIs represent the key drivers and the critical success factors of the hospital, which need to monitor the results of these performance metrics to determine the quality of its financial and operational activities.

What is the Value of the KPIs?

KPIs provide significant values to any hospital that utilizes them to

  • Choose the most important indicators for the hospital.
  • Set the goals (using benchmarks)
  • Create action plans to achieve the goals.
  • Implement the action plans.
  • Monitor the results of the implementation.
  • Communicate the results back to the affected parties (Feedback)
  • Development of positive and negative consequences based on this result.
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What is the Best Practice to Determine the Quality of a Hospital’s Financial and Operational Activities?

  • Recognize your key organizational success drivers.
  • Set the level of these drivers (goals), Most often through strategic and operational benchmarking.
  • Manage the achievement of these goals.
  • Foster accountability through the recognition of the achievement.
  • Set salaries, bonuses, and promotion levels based on goals and outcomes.

KPIs Elements

KPIs come in so many different types, so every organization is likely to choose different KPIs, based on their usefulness, importance, ability to measure, and its effect by a variety of factors:

  • Location.
  • Payer mix.
  • Tax status.
  • Profit target “For‐profit, nonprofit, governmental, military”.
  • Reporting periodic “Daily, weekly, biweekly, monthly, quarterly, annually”

KPIs Categories

As there are so many KPIs, and by time you will add more and more KPIs to your reports to increase efficiency to your hospital performance, so we should categorize these KPIs such as:

  • Operational KPIs
  • Financial KPIs
  • Communications KPIs
  • Internal KPIs
  • Emergency (room/area) KPIs
  • Medical care KPIs

Which KPIs Should I Choose?

To choose the right KPI, you need to know what you want to measure? and why? And then you need more and more practice and comparisons, in this level, you will add some new KPIs to your report and delete others.

There is a list of some KPIs/metrics used for monitoring/evaluation of the hospital business process divided into categories:

Operations KPIs

Patient Waiting Time

Calculates the average amount of time a patient must wait between checking in and seeing a provider. It can help with staffing and scheduling and provide insight into patient satisfaction.

Average Number of Patient Rooms in Use at One Time

Shows how well space is used to treat patients and helps determine if more or less space is needed in the facility.

Staff-to-Patient Ratio

Indicates the use and capacity of staff resources. This can affect the quality of patient care.

Bed/Room Turnover

Demonstrates how fast patients are moving in and out of the facility. It affects the efficiency of the facility and should be considered when looking at patient satisfaction.

Admission Rate

Enables organizations to know how many patients they have coming in. The growth or decline in this number can help with decision-making regarding marketing, hiring, equipment, and space.

Readmission Rate

Calculates the rate of patients who come back to the facility shortly after they were seen. If high, it can indicate a lack of staff, experience, or attention during treatment.

Occupancy Rate

Indicates the use and capacity of the facility and can help determine if more space is needed.

Average Length of Stay

Shows how quickly medical staff can diagnose and prescribe treatment that does not require a further stay. Also helps the facility predict how many patients they can bring into the facility during a specific time frame.

Number of Patients Served Per Month

Tracks the number of individuals receiving care each month.

Number of Beds

Shows the capacity of the organization and how many patients it can hold. You may need to break it down into different units/bed types.

Number of New Patients

Measures the number of unique individuals who were first-time patients during the reporting period.

Average Minutes Per Surgery

Demonstrates efficiency with scheduling. You may need to also track the average time for different procedures since they may vary widely.

Operating Room Turnaround Time

Calculates the time it takes to clean and prep the operating room before procedures, impacting the number of procedures scheduled.

Average Lab Test Time

Measures the average amount of time it takes to run a test in the laboratory.

Staff Overtime

Demonstrates the amount of time that staff is needed to work over their normal hours. This may indicate that the facility has too many or too few staff resources.

Energy Usage

Measures the amount of energy the facility uses. This affects the overhead costs of the organization.

Financial KPIs

Average Cost Per Discharge

Averages the cost that the facility incurs for a patient’s entire stay.

Total Operating Margin

Demonstrates an organization’s operating efficiency. It also affects the organization’s pricing strategy.

Claims Denial Rate

Provides insight into the effectiveness of the organization’s revenue cycle. A low claims denial rate means that the organization has more time to focus on patient care and spends less time on paperwork.

Indirect Expenses

Records the overhead expenses that supplement the direct operations of the facility. They can affect the pricing of services.

Labor Cost

Compiles the total cost of salaries, wages, and employee benefits. It affects the price of treatment for patients as well as the satisfaction of employees.

Patient Transactions

Tracks the number of patient transactions during the reporting period.

Average Treatment Charge

Shows the average amount that a facility charges a patient for treatment. It can be broken down by treatment or shown as an average of all treatments or treatment categories.

Permanent Employee Wages

Records the value of wages (including bonuses) paid to all full-time employees during the reporting period.

Third-Party Revenue

Records revenue earned from the government and other third parties, such as insurance companies.

Medicine Costs

Shows the amount that the organization is spending on medicines used to treat patients.

Equipment Maintenance Costs

Measures the cost to maintain equipment throughout the facility.

Percentage of Patients Without Medical Insurance

Calculates the percentage of patients that do not have any kind of medical insurance.

Percentage of Patients With Public Insurance

Calculates the percentage of patients that have public insurance.

Percentage of Patients With Private Insurance

Calculates the percentage of patients that have private insurance.

Communications KPIs

Number of Press Releases Released

Tracks the number of press releases your organization sends to the media so that you know how much exposure you’re receiving from news sources.

Number of Media Mentions

Keeps track of how often you’re mentioned in the media. This could include the news as well as social media. You may want to consider tracking positive and negative mentions separately.

Number of Fact Sheets Developed

Counts the total number of materials created, which supply information to patients and act as a marketing tool.

Overall Patient Satisfaction

Calculates satisfaction levels by combining several factors. It can be a great marketing tool for your organization if it’s high. A low number could signal a problem with other operations or services.

Number of Patient Complaints Filed

Logs the number of complaints filed by patients before, during, or after their period of care.

In-Patient Satisfaction With Physician

Communicates the level of satisfaction among patients admitted to the healthcare facility.

Outpatient Satisfaction With Physician

Communicates the level of satisfaction among patients who receive care without being admitted to a hospital.

Percentage of Patients That Found Paperwork to be “Clearly Written & Straightforward”

Demonstrates whether a healthcare organization has ensured that written materials have clear instructions that patients can understand easily and respond to.

Percentage of Medical Documentation Translated

Demonstrates what lengths are taken to accommodate diverse populations.

Money Spent in Marketing & Advertising

Includes money spent increasing awareness of the organization, including services that are offered, ratings, and patient testimonials.

Number of Website Hits

Displays the amount of traffic going to an organization’s website.

Percentage Increase in Subscriptions to Newsletter

Calculates the percentage increase in newsletter readership, demonstrating the level of interest in the healthcare facility’s operations and events.

Internal KPIs

Number of Employees That Participate in Internal Training

This indicates that your organization cares about the qualifications and training of your workforce.

Training Per Department

Tracks the amount of training that each department provides or requires of their staff.

Percentage of Employees That Find Internal Training Useful

Shows the effectiveness of your internal training. If it is low, it may indicate that changes need to be made to internal training so that it benefits the organization and employees.

Average Monthly Full-Time Equivalents

Affects the cost of your workforce and how many patients you can treat.

Employee Turnover Rate

Shows how steady the workforce is for the organization and can affect the level of care and effectiveness of the facility.

Employee Satisfaction

Gauges the satisfaction level of employees, which can majorly impact turnover rates.

Total Number of Training Hours

Calculates the total number of training hours provided to employees.

Percentage of Electronic Health Records

Demonstrates how technologically advanced an organization’s record system is.

Referrals

Shows the number of patients that were referred to another facility. It may indicate that the facility is losing revenue to other providers and needs to hire more specialized employees or acquire new equipment.

Number of Mistake Events

Gauges the number of mistakes that are made in the organization. You can track by mistake category. Can indicate the effectiveness of employees and equipment.

Impact of Mistakes

Shows how crucial the mistakes that employees make are and can help determine what steps need to be made to further prevent mistakes.

Patient Confidentiality

Measures the number of times a patient’s confidential medical records were compromised and seen by an unapproved party.

Advocacy/Policy KPIs

Charitable Donations

Tracks the dollars spent on donations to other organizations. This could include advocacy groups, research organizations, or other healthcare organizations.

Adolescent Obesity Outreach Campaigns

Demonstrates the amount of time and dollars spent on educating adolescents on the causes and effects of obesity.

Corporate & Foundation Giving

Shows the value raised from corporate and foundations’ gifts.

Planned Giving

Shows the amount raised from individuals’ gifts or commitments, usually a part of an estate or financial plan.

Public Support

Calculates the money raised from local, state, and federal government funding.

Total Fundraising Expenses

Shows a total dollar value of expenses incurred for fundraising events and campaigns.

Gross Funds Raised

Indicates the effectiveness of fundraising campaigns for donations to another organization or for funds raised for internal use.

Cost to Raise a Dollar

Calculates the money spent to raise a dollar for the organization’s mission by dividing the fundraising expenses by gross funds raised.

Number of Partnerships With Advocacy Groups

Counts the number of relationships established with other organizations. A high number of partnerships can increase the impact of campaigns and policy events.

Emergency Care KPIs

Patient Waiting Times by Process Step

Shows the amount of time a patient must wait during their visit to the emergency area of the facility.

Arrival to Bed

Calculates the amount of time a patient must wait before they are taken from the waiting room to a bed.

Arrival to Nurse

Calculates the amount of time a patient must wait between their arrival and seeing a nurse.

Arrival to Physician

Calculates the amount of time a patient must wait between their arrival and seeing a physician.

Arrival to Discharge

Calculates the total amount of time a patient is in the emergency room, from the time they arrive to the time they are discharged.

Number of Rapid Response Vehicles

Shows the number of emergency vehicles available at the facility.

Time Between Symptom Onset & Hospitalization

Gauges the amount of time a patient begins experiencing symptoms and when they were hospitalized.

Number of Trauma Case

Demonstrates the number of trauma cases that occur in the facility.

Number of Visitors Who Left Without Being Seen

Indicates the number of people who were unwilling to wait to see a physician. May show if more beds or staff are needed to handle the number of patients coming in.

Code Response Time

Measures the amount of time it takes for staff to respond to an emergency code in the facility.

Care KPIs

Medication Errors

Measures the number of times there is an error in prescribing medication at the facility. Includes when a mistake is made in the medication, patient, or dosage and applies to inpatient and outpatient services.

Patient Care Hours

Shows the amount of time that healthcare workers spend directly with patients.

Patient vs. Staff Ratio

Demonstrates the number of staff available per patient. May indicate whether the facility is overstaffed or understaffed.

Patient Retention Rate

Shows how many patients come back to the facility for another unrelated visit. It is related to patient satisfaction.

Rate of Complications

Indicates how many patients have complications related to the care they received at the facility.

Post-Procedural Death Rate

Shows how many deaths occur at the facility following a procedure.

Quality of Nursing Care

Shows if patients are satisfied with the level of care they received from nurses during their time at the facility.

Patient Follow-Up

Measures the number of patients who receive follow-up after they visit the facility. This could be from a physician, nurse, or other staff member asking about the visit and the patient’s improvements.

Hospital-Acquired Conditions

Quantifies the number of conditions acquired during a patient’s stay at a healthcare facility, such as reactions to prescriptions or pressure ulcers.

Unexpected Return to Surgery

Measures the number of patients who must return to surgery unexpectedly because of complications during surgery.

What makes KPIs become just a useless number?

  • Sitting KPIs without reference any specialized scientific and technical references, therefore it will not be possible to make any Benchmarking with any external sources.
  • Setting targets randomly not based on logic or experience, and not suitable either by priority or conditions “targets shouldn’t be specific numbers, but there must be a range to move through”
  • Not to link these targets with specific work programs, responsibilities, capabilities, and timings to deal with the gap between the target and the current situation.
  • Without this discipline, anyone will do what he thinks, then blame any elements when they do not achieve the target.

Conclusion

  • KPIs represent the key drivers and critical success factors to the hospital.
  • KPIs are developed to measure the results of organizational policies, practices, and procedures.
  • KPIs can provide significant value to any hospital that utilizes them, particularly to
    • Set the goals.
    • Clearly present the results to enhance decision-making.
  • Do not judge the performance at a point in time, but measure the evolution of your performance over time, which is the most important.
  • Numbers are not enough Think further, circumstances, reasons.
  • Evaluation is not a chat, it must happen based on detailed KPIs, statistics, metrics that analyze and explain the change in performance.
  • Healthcare organizations need to ensure that they use KPIs to maximize their outcomes, direct it to achieve the best possible achievement, and not simply to evaluate the performance of employees.

Please don’t forget to share your thoughts and best with HBC in the comments and let us know your opinion about the measurement KPIs you use in your healthcare facility. If you have valuable content to share on Healthcare Business Club you can publish your content for free, please don’t hesitate to contact us at any time.

Ahmed Ezz Eldin
Ahmed M. Ezz EL-Din, MBA - is a Senior Cost accountant for healthcare services in Egyptian General Authority of Health Insurance, Former member of the Standing Committee for Pricing of Medical Services in universal health insurance (UHIO), experience in calculating healthcare services costs and preparing price lists for health care services, has established the cost system in many governmental and private hospitals also participated in preparing healthcare service price lists in the Egyptian Ministry of Health and Universal Health Insurance (UHIO)

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