Don’t Inhibit Your Hospital Efficiency by Trying to Measure It Manually

by Houston Klassen, Executive VP at Infinite Leap

The business of delivering care is beyond complex, and the demands put on all types of healthcare workers is extraordinary. Not only are there all the requirements any business would have to be efficient and productive, but those employed in the delivery of healthcare know very clearly that the work they do directly impacts the care, experience and, most importantly, the very lives of those entrusted to their supervision. The pressure and stress created from that type of work environment is only equaled by the personal fulfillment these people gain from knowing that what they do means so much. Yet every single day, these caregivers find that much of their workday is spent doing things they never could’ve imagined as they dreamed about a career helping people. More and more, they are asked to engage in activities that could inhibit their ability to do their best for the patient. It’s frustrating to see for those of us on the outside, and I can’t even imagine how frustrating it is to work in that type of situation.

On the other hand, as a business leader myself, I completely understand that there are certain activities that need to be done by someone to run an efficient business. It is not always possible or practical to eliminate all the tasks that can clutter the important work of the day. One of the biggest challenges I see is that most businesses – certainly the best operations – subscribe to the belief that to effectively manage, they must be able to measure critical performance and operational metrics. Having this information allows for analysis and decisions to be made on any number of matters. Without it, we are forced to rely on gut feeling, experience or intuition.

The problem with this is the collection of the data must fall to someone, or everyone, and it generally ends up being one of those “other tasks as may be assigned.” And as managers continue to try to better manage responsibilities and teams, we continually look for more data – meaning more information is asked to be collected. That means we are adding new data collection tasks to our team, which eventually starts to crowd out the things that people were hired to do! It’s almost as if we inhibit efficiency by trying to become more efficient.

So… what is the answer? Should we stop trying to understand our businesses so that our teams can just do their work? I don’t believe that would be wise, nor do I think we could ever go back to that method of management. In healthcare, the economics and overall system mandates that we all need to become more efficient – and with the vast size of most healthcare systems, the only way to manage for effectiveness is to make fact-based decisions as quickly as possible. We are in the age of data, and we know that measuring and managing based upon fact is the right thing to do. Instead of trying to figure out who to assign to the next “science project,” the focus needs to be on ways to collect the data automatically and remove a burden.

There’s been a lot of progress in this area. The move to electronic health records has helped by working to consolidate the collection of information in a single place, providing easier access to those who need review and share information about a patient. Yet even that record, as good as it is, requires that care providers manually enter an enormous amount of data. Some of that situation makes complete sense. For example, I would expect that my physician uses her education and vast experience to capture information about my health situation. She can talk to me, ask me questions, look in my eyes and conclude a great deal of information about my health because she’s known me for years. That’s all understandable.

However, I also know that during a normal visit, I’ve seen the care staff have to manually document a lot of information that, frankly, required no education and no experience to capture with complete accuracy. Much of this information is required simply to understand my movements through the daily workflow of the clinic/hospital, as well as to make sure that the proper steps are followed. To have a clinical staff member manually enter that I’ve moved from room A to room B is almost laughable. Yet this happens hundreds of thousands of times per day across the healthcare industry.

Likewise, we see care providers being asked to do all kinds of other data-capturing activities, such as monitoring and recording the temperatures of refrigeration units or the movement of lab specimens, and manually making dozens of phone calls to check on the status of other staff, patients or processes. Add to this the fact that the average nurse spends 20% of their daily shift looking for things and people and it is not at all out of line to consider that north of a third of a care provider’s shift is spent doing things that have no correlation to delivery of care.

In a time of nurse shortages and hospitals trying to have more efficient staffing schedules, it seems a bit ludicrous that we are effectively taking a third of our care provider payroll and spending it on things that I would consider non-value added tasks.

This situation seems even crazier to me when we live in an era of incredible advances in technology and all-time low costs of these technologies. My thesis is simple: Let’s automate all the things that we can automate and give as much of the day back to care providers to care for the patient. This makes sense from a purely financial and HR perspective – if we can’t find nurses, let’s use the nursing talent we have as best possible to deliver care – but imagine what this refocusing of skill will do for patient experience and outcomes. Further, and certainly not least important, I’ve yet to meet any care providers who went into these fields to enter data into computers, or log activities on a clipboard. Where we have been able to automate processes, clinician satisfaction increases, which has a whole host of benefits.

Beyond giving time back to providers, it is easy to see that using technology to monitor and automate will provide us with much more consistently and accurately collected data than we could ever achieve by asking people to do the same. That’s not to mention that we can ensure the timely delivery of this data to the right person or system – whereas when we ask clinicians to manually log data, we can’t be sure it is happening in as timely a manner as we’d like. (That’s no fault of the clinician, but honestly, when a patient needs attention, would you rather have the clinician entering data or putting that on hold to address patient needs?)

In practice, we’ve been able to witness the positive impacts of these automation efforts in both the delivery of care and by getting better, more timely data to leadership from which to make decisions. That’s led to impacts such as providing documented instances of millions of dollars of care provider time back, improving regulatory compliance in all types of areas and automating communications, which eliminate the hundreds of phone calls that used to be required to make sure everyone knew what was happening. There are more examples than I can even begin to properly document in a simple article like this. The trick is in figuring out how to do this effectively and in a way that is affordable.

Our experience has shown that trying to address any single one of these automation efforts alone is often not a practical approach. When we can articulate all opportunities to automate processes, we can design a single technology architecture that it is not only impactful for the entire organization but affordable and well worth the effort. And when we can leverage the existing systems and investments already in place within a hospital, it is a decision that simply makes sense.

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