Healthcare facilities, such as hospitals, must keep track of and work to enhance a large number of financial and quality measurements. As CMS keeps incorporating and modifying quality programs, hospital managers are having a hard time concentrating on the most important and easy to enhance metrics.
Naturally, each establishment will likely concentrate on certain measurements based on their current and desired performance. Some hospitals may focus on attempting to maximize profit, while others could prioritize attempting to improve the level of satisfaction of patients. Before delving further, let us first explain what these metrics involve.
Why is Monitoring Healthcare Metrics Important For Your Practice?
Hospitals must take into consideration the excellence of their offerings, what the patients require, and what they have available when managing their facility just as any other business would.
Nevertheless, this may be challenging to accomplish if you don’t assess your medical facility’s output using healthcare metrics.
Without monitoring healthcare metrics, you will be unaware of how your practice can be enhanced and how it is ranked compared to other clinics.
But, by evaluating the care you provide from the moment a patient steps into your healthcare facility to the moment he leaves, healthcare metrics can help you to:
- Measure the effectiveness of your healthcare practices
- Reveal the areas which need improvement
- Improve patients’ experience and increase their satisfaction
- Ensure you’re using your resources in the most optimal way
- Reduce healthcare costs
Additionally, if you intend to obtain certifications from either a national or international authority, your clinic’s activity must meet the requirements set forward by the documented accrediting body.
Checking and keeping track of healthcare KPIs is an essential requirement – it assists in increasing the output of your clinic and establishes that your clinic meets the criteria of accreditation.
What are Hospital Quality Metrics?
CMS has created a set of rules to measure healthcare activities, medical results, and organizational makeup, known as hospital quality metrics.
In value-based payment models, provider reimbursement rates are altered based on quality metrics. If a provider surpasses the required standards, they will be awarded a bonus, and vice versa if they are unable to meet the standards.
Here is a list of the top 20 key indicators that hospitals should monitor.
1. Length of Stay
Duration of hospitalization gauges the time period between a patient’s entry into and release from a hospital. This figure is generally monitored across periods of months and yearly three-month intervals, yet it can also be kept track of over the course of some weeks. The amount of time spent in a hospital may be studied for the entire facility or for a particular treatment area like AMIs.
This information is significant because it measures the efficiency of care over an extended duration. Prolonged inpatient stays are associated with higher possibility of HAIs, HACs, and increased patient mortality rates.
Interestingly, cardiac patients are an exception to this rule. People with heart failure who are admitted to hospitals have fewer deaths and shorter stays, however, they may need to be admitted to a hospital again at a later date. There is a danger of discharging people too soon without recognizing the possibility of life-threatening risks.
Patient length of stay also impacts hospital financial performance. The amount of money needed to provide care increases proportionally with the length of a patient’s hospital stay. Aside from patient treatment expenses, CMS rewards shorter stays whenever it is feasible, offering financial rewards to bring down the time a patient must stay in a hospital for a period of treatment.
2. Readmission Rates
The readmission rate signifies the portion of patients who have to be admitted to either the same or different health facility within a month after being released from the medical center for similar or possibly linked troubles. This measure evaluates the level of care patients receive.
An unusually high rate of people returning to hospital for care suggests that medical staff have not supplied the correct treatment initially, overlooking any issues and relevant details about the individual. Hospital readmission rates that are low signify that the level of care being provided is exceptional.
Based on Definitive Healthcare data that is the most up to date, the all-cause hospital readmission rate for 2021 is 15.5%. At the Pittsburgh VA Medical Center in Pennsylvania, over 20% of those discharged were readmitted to the hospital within thirty days of discharge. The readmission rate at the Hospital for Special Surgery in New York was the smallest, coming in at 11.5%.
Hospitals may face revenue losses because of high rates of patients returning for additional care. Hospitals with the greatest amount of people being readmitted may not get the complete amount of Medicare compensation as a form of punishment.
It is difficult to find the balance between the amount of time each patient spends in the hospital and the amount of patients admitted again shortly after discharge, but it is essential for the patients’ wellness as well as for the financial stability of the hospital.
3. HCAHPS
The HCAHPS survey evaluates 64 parameters of patient gratification. The study surveyed aspects such as the adequacy of care and maintenance of the care center. The survey outcomes are revealed by assigning a score out of 5 with 5 being the maximum marks. HCAHPS scores offer specifics concerning what hospitals can do to enhance the care and services offered to patients.
Complaints about the HCAHPS process typically point to the oversimplified nature of the star rating system. Hospital administrators allege that the ratings are inaccurate, because they do not give a complete representation of the quality of patient care.
Experts worry that the system puts poorer and more vulnerable people at a disadvantage; specifically, it can hit hospitals that treat lots of patients hard. Average daily count of inpatients is the average number of people admitted to the hospital within a 24-hour period.
Out of the total 3,110 different medical centers that were given a HCAHPS star rating, only 178 of them were able to reach the maximum 5 star score. This is less than 6% of the total. In 2021, approximately 886 hospitals were given a 4-star rating, representing 28% of the total.
4. Mortality Rates
The percentage of patients who pass away while under a hospital’s care, before they can be released, is known as the patient mortality rate. This measure is a good sign of how successful healthcare providers are in controlling a patient’s situation after surgery or any other medical procedure.
Statistics from Definitive Healthcare show that, in 2021, the fatality rate for heart attacks stands at 12.6%, the most up to date information obtainable. Both Doctors Medical Center Modesto in California and Franciscan Health Dyer in Indiana had the highest death rate when it came to heart attacks, both with 16%. At Mayo Clinic Hospital – Saint Mary’s Campus, the mortality rate was the least, standing at 8.7%.
5. Bed Utilization Rate
The proportion of beds in use in a hospital at any given moment is referred to as the bed utilization rate. Having an awareness of how much demand there is for beds at any given time is vital to health care providers so they can distinguish the number of beds that can be used versus the amount of people who need medical assistance.
Balancing bed availability can be difficult. If the number of patients is too low, the hospital may be incurring financial losses due to excessive personnel and upkeep of the facilities. If the number of patients admitted is more than the clinicians available to care for them, then the quality of the care they receive could be negatively affected.
Definitive Healthcare figures show that the normal rate of beds being filled is 49.9%. The speed of service is larger in urban medical centers as opposed to rural medical centers. Urban medical centers generally use 57% of their beds, whereas country hospitals on average use 36%.
6. Incidents
Unintended results and results of medical facility activities, for example, sepsis, post-operation breathing issues, pulmonary blood clots, blood spillage, and different responses or diseases, are on the whole considered hospital episodes. This metric evaluates the capability of healthcare professionals to deliver comprehensive and superior care to patients with no adverse consequences.
It is essential to log hospital occurrences in order to get an idea of the level of care a medical center is giving. Events offer solid information on what activities a medical facility should execute to both enhance its facilities and lessen patient mortality and re-entry rates. Startling figures from Definitive Healthcare have revealed that 758 health care facilities have been imposed a penalty for conditions contracted in them in the current financial year.
7. Patient Wait Duration
The amount of time a patient needs to wait until they are seen by a healthcare professional is determined by working out the average wait time and dividing it by the amount of patients. This healthcare KPI can be useful in pinpointing the necessity of staff and planning and improving patient contentment.
8. Emergency Room Waiting Time
This healthcare key performance indicator is similar to the time it takes for a patient to be seen in an emergency room, just more specifically honed in on emergency room wait times. The average amount of time it takes for a patient to get their initial treatment when they arrive at the emergency room is tracked by dividing the overall wait period by the amount of patients.
Tracking this measurement can enhance your hospital’s emergency department effectiveness by determining busiest times so you could establish proper scheduling and staffing modifications.
9. The Number of Patients Leaving Before Seeing the Healthcare Provider
This healthcare key performance indicator tracks the number of patients who have departed the medical center prior to their appointment. This healthcare KPI has a tendency to be associated with other healthcare indicators, for example, the ratio of workers to patients and the length of time patients wait. This is a healthcare metric that signifies hospital efficiency. If the number is large, it is an indication that changes should be made to maximize your efficiency and make your patients more content.
10. Cancellation Rate
This key performance indicator monitors the proportion of cancellations within your healthcare institution. Therefore, it is a valuable healthcare indicator to decrease unnecessary consumption of resources and boost patient visit rate (along with their pleasure).
11. Patient Medication Cost
By dividing the amount spent on medication by the number of hospital stays, a good measure for gauging the cost effectiveness of medical care can be established. This makes it easier to monitor and adjust your spending appropriately. Having your staff keep track of the cost of medication can prevent prescribing something that either the patient would struggle to finance or their insurance doesn’t cover.
12. Average treatment charge
This measure of healthcare can show how productive and successful your medical center’s treatments are by dividing the full cost of the treatment by how many treatments there were. You could look into the mean expense of fertility treatment administered by your clinic and contrast it to other clinics. If the cost of your bill is much higher than normal, it is necessary for you to monitor how you spend your money. This healthcare Key Performance Indicator is helpful if you are trying to lower hospital expenses.
13. Average Discharge Cost
This healthcare KPI demonstrates the average expenditure for a patient at the time of dismissal from a hospital; it is computed by dividing the total cost of the discharge with the amount of departures. By keeping track of this metric, you can observe which types of care (heart, cancer, emergency treatment, etc.) are the most and least productive, making it a helpful metric to observe to keep from expending too greatly.
14. Employee Compensation
This healthcare Key Performance Indicator gauges the amount of money that your health care center uses for employee salaries. This metric is beneficial in order to properly control money within your medical center and make sure you don’t pay either too much or too little to those who work there. If the health care KPI is poor, it could be indicative of a financial savings, however that would come with lower quality services likely due to a lack of motivation among employees, a shaky staff retention rate, or a low staff-to-patient ratio.
15. Net Profit Margin
Dividing the net income by the net sales, this critical healthcare gauge shows the level of profit the hospital obtains for every dollar after expenses are removed.
16. Average Insurance Claim Processing Time
This healthcare indicator is essential to controlling money movement as it records the amount of time various insurance businesses take to give payments to your medical center. If the healthcare key performance indicator is not satisfactory, then your hospital is not getting paid in a timely fashion. You can also keep track of the average expense of handling insurance claims.
17. Bed Turnover
This healthcare KPI figures out the speed at which patients enter and leave the hospital by splitting the entire amount of discharges (including deaths) by the total number of beds in the hospital. It is necessary to pay close attention to this specific healthcare KPI in conjunction with the readmission rate due to the possibility of the same patients being readmitted not long after being discharged. If the speed is exceptionally tall or very small, your medical center may not be taking full advantage of its assets. If the healthcare KPI is unusually low, the likely reason would be because the hospital may be short-staffed, inadequate training, or other concerns. In addition, you could possibly be losing capital as your health facility is not running as productively as it could.
18. Account Receivable (AR) Turnover Rate
This healthcare metric determines the effectiveness of the hospital in receiving payments, whether they come from insurance companies, patients, or governmental bodies, by calculating the net credit sales divided by the average AR. This suggests that if your hospital has a low amount of Accounts Receivable turnover, it may be having trouble getting paid, whereas if the turnover rate is high, money is being paid promptly.
19. Staff Training By The Department
This healthcare measure keeps track of the total amount of hours of education the staff in each division of your medical facility has had. This healthcare KPI can also calculate the sum of education that all employees have together obtained. You can determine the amount of instruction by type, for example how many hours of emergency preparation your workers have gone through.
20. Media Exposure
This healthcare statistic tracks how often your healthcare facility has been mentioned in the press (television, newspapers, etc.). It is recommended that one measure both the favorable and unfavorable press notices separately in order to either draw more patients and gain more profit or impair the healthcare organization.