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Why KPIs and KLoEs Aren’t Really Driving Continuous Improvement and Statistical Analysis in Healthcare

How the right performance management solution helps you avoid the "messy middle"
a man looking at a the inphase oversight quality app on a laptop
| Robert Hobbs | Healthcare

For healthcare providers, Key Lines of Enquiry (KLoEs) and Key Performance Indicators (KPIs) are an integral part of the culture, as they help ensure that the services they provide meet fundamental standards of quality and safety. Audits and inspections (such as those performed for the Care Quality Commission) often take up vital time and resources as they collect commentaries and evidence to ensure those standards are reached.

However, all too often, this wealth of information isn’t used to the best advantage of the individual trusts. While it’s an essential part of the process to satisfy regulatory requirements, these valuable insights into current practices and standard operating procedures are often lost amidst a hodgepodge of meeting notes, spreadsheets, databases and outdated survey tools.

Then the next inspection kickstarts the same exercise of data collection and collation, and the cycle repeats…and repeats…

However, some trusts were determined to take the insights they’d uncovered and make the best possible use of them, so they invested extensively in a business intelligence layer or analytics tool that sits neatly on top of their individual directorate systems and data warehouses to give them a more holistic view of the real-time situation. Those investments have helped them improve their decision-making and helped them react to environmental factors much more quickly.

These advances have also allowed hospital trusts to answer the question “where are we now?” but they’ve had little influence on answering the real question which is “how do we get to where we want to be?”

The system can show individual KPi or KLoE prompts and apply RAG (Red, Amber, Green) status, but underneath that KPi, out of sight of the business intelligence tools, are the real drivers and projects which are affecting the cause and effect. This layer of performance management becomes even more difficult to understand when individual directorates are running multiple projects which can all have a positive or negative effect on an individual goal. This is the mess in the middle.

  1. Valuable insight from frontline services, collecting numerous individual pieces of information to fulfil a regulatory or inspection process. This is “where we are today”.
  2. Trust or directorate-level strategic plans that detail how services can be improved and paint the picture of tomorrow and allocate budgets and resources. This is “where we are going”.

But the two seldom meet in the middle. The messy middle layer is too slow, inaccurate and ineffective due to the complexities of the thousands of individual streams of information.

This is where modern cloud-based performance management solutions can replace the mess with coherent messages, actions and tasks - all with the overall goal of the trust at the core.

But those solutions need to be much more than just visualisation tools - they need to be built around the concept of continuous performance improvement, to provide a structured mechanism for trusts to see “what is happening today.” More importantly, they need to provide a framework to understand what the organisation is doing about it and whether the actions it’s taking are moving it towards its stated objective.

Modern performance management solutions allow any individual care giver, regardless of their technical skills, the ability to analyse these complex problems and see the results of their actions. An individual KPi or KLoE can be broken down by divisions or directorates so you can easily understand the real drivers behind the results and assign actions or change procedures accordingly.

Modern performance management techniques are continually evolving, but they’re still built on the same fundamental principles:

  • Achieving better / more accurate / safer results with the same or fewer resources, so as to build on the fundamental principles of aspiration and achievement.
  • Targeting needs to be set in incremental, achievable stages, to improve results and build towards the organisation’s overall goal.
  • Reviewing those targets regularly and rolling them up to the organisation’s annual goal.
  • Conducting regular reviews based on accurate, real-time data to give the best possible representation of the real-life situation.

For healthcare providers the ‘messy middle’ can seem a very daunting place where the best efforts of frontline providers are somehow mapped onto an overarching organisation goal. The vision and roadmap forward are often lost in complexity and in an incomplete understanding of the real-time situation, and this leads to miscommunications and plans that can seem out of reach.

InPhaseOversight can give these actions clarity, and service providers can see why a red, Amber or Green status is the colour it is and be empowered to affect the end results. Because it’s been designed to support the process of continuous improvement, it gives you the framework you need to create organisational plans and the actions associated with them. Once those plans are underway, it identifies any gaps using real-time data from numerous sources so that they can be addressed. And as the plans evolve and adapt to change, it gives you the mechanism to handle those changes - ensuring you achieve your desired outcome.

screenshot of the inphase platform showing a CQC assessment summary reporting page

Once healthcare providers have tackled the messy middle, then and only then will all of that invaluable information from each individual KPi and KLoE start to flow into a unified view of the trust. This can be enhanced with data from other applications, such as patient management systems which will allow individuals to say “this is where we are now, this is where we want to be, and this is how we’re going to get there.

Robert Hobbs

Chief Executive Officer

InPhase’s Chief Executive and Founder, Robert has been the visionary leading InPhase to be one of the UK's leading providers of management, governance and assurance solutions, and helping organisations align their actions and goals more easily and efficiently with InPhase's suite of integrated apps.

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