From Insight to Action: How the Center for Case Management structured dashboards and efficiency scores to align with a best practice library and enable Case Management departments to improve outcomes and influence hospital metrics.
The concept is simple, but when an organization considers the true complexity and scope of a Case Management department, “simple” can quickly unravel. A Contemporary Case Management department influences significant organizational metrics from capacity to revenue. This department will draw data from a multitude of different operating segments within the organization and leverage several unique workflows, only compounding the overall complexity. Not to mention the inherent difficulty of building a data glossary and set of metrics and dimensions that can communicate across disparate systems.
A fully integrated and effective case management dashboard is no easy task. It is one thing to put your top 25 metrics on a front page and color code them, but if we have learned anything from the discipline of Neuroscience, we know that’s a recipe for failure. According to David JP Phillips, the cognitive resources required to interpret data and react to information increases 5-fold when we place more than 6 key elements on a slide. Additionally various executives within the organization will view the data through a different lens. The same can be reasonably extrapolated for dashboard design. In order to deliver data in a manageable way, without creating fatigue, an effective summarizing system is needed that guides the user to true process or outcome variation. It is critical to have a standardized case management dashboard that is created to send a consistent message and allow the department to respond with an action plan.
The Center for Case Management has developed a suite of products that will enable Case Management departments to organize their data, identify areas of opportunity, and draw from a best practice library as they move from insight to action. CARTBoard™ is a vendor agnostic dashboard solution and data structure that can be adapted to your organizations data model. Here are some best practices that your organization should consider when investing in a Case Management Dashboard design.
Lesson 1: Getting Organized/Identify key data points
Human centered design should be at the center of your dashboard preparation. Data is not aggregated to a given page or set of visuals because of its existence in each module or portion of your IT Infrastructure, but instead, Metrics should be organized into functional areas that follow the workstream. The Center for Case Management identified four high level breakdowns that apply to all case management organizations, which include Clinical Case Management, Access Point Management, Revenue and Utilization, and Transitions. These summary areas created the basic model for CARTBoard™ and additional breakdowns are defined within each area.
Lesson 2: Develop an Effective Summary System
Striking a balance between the highest value metrics and a set of summary scores to communicate efficiency or outcome achievement is important. Case Management covers multiple areas and attempting to display all the key metrics for the department on one page, in a color-coded format is a distraction nightmare. Following the tenants of lesson 1, a structure enables logical order and organization for department leaders, and the use of a weight-based summary score for each ‘high level area’ properly draws focus and attention.
The Center for Case Management identified key measures that can be embedded in a summary scoring product that follows the four high level breakdowns: Clinical Case Management, Access Point Management, Revenue and Utilization, and Transitions. Much like a car’s dashboard, the summary system ties together high value visual trending graphics with a set of warning indicators to guide the user to key areas that should be examined.
Lesson 3: Create balance with Outcome Measures, Process measures, including data integrity and process efficiency
All too often, Dashboards and Data summary metrics for the Case Management department miss the overall narrative that weaves together a story, from process to outcome. Following the rules from the previous two lessons, the dashboard should move the user from a summary view to subsequent levels of detail. Within these detailed views, identify the narrative that links from process to outcome.
An important but sometimes forgotten attribute of process measurement, is process adherence and data integrity. Simplified means of monitoring for adherence to these processes, such as thorough assessment documentation (data capture), avoidable day capture, and appropriateness of UR review criteria set should be represented in process monitoring. CARTBoard™ leverages over 20 unique Case Management specific process and outcome metrics paired with a host of standard content metrics that are blended together to form a complete picture and identify opportunities.
Lesson 4: “No data have meaning apart from their context.” - Wheeler, 2009
Common mistakes made in dashboards today include compromising on space (visual real estate) and sacrificing the graph. Remember, “Two data points don’t make a trend” – Graban, 2019. When developing metrics, in summary form and expanding detail, ensure that you are escaping the cult of the average. Take Emergency Room Boarding times as an example. Let us say the organization set a goal that patients should board (or wait) no more than 4 hours. If we render an average of all emergency admissions and get a result of 3:44, is that success? What if, additionally, we look at the % of admissions that take > 4 hours and create a means of exploring the process elements (like the occupying unit, doctor, service, diagnosis, weekday, and other time factors).
It can be tempting to jump to conclusions or call a data tool ready for prime time. Ensure that your summary and associated details are prepared to support data exploration, and suppress ‘noise’ with process control charts, and other tools to address variation.
Lesson 5: Influencing Outcomes
A compelling dashboard is only part of the overall recipe. Organizations need to create dashboard tools that allow for interactive data exploration that offers logical data hierarchies and inter-connected fact pages so leaders can chase story lines and provide answers in a timely manner. Identifying the most meaningful data set to start with can be daunting, given the scope of coverage. When an improvement opportunity is identified or a regulatory reporting requirement is necessary, creating an action plan and implementing changes can be equally challenging. Teams often turn to literature and best practice papers to identify the ideal change solution, hopeful that the best solution was identified.
Linking back to lesson 1, the Case Management Department should have access to best practice libraries that align with the high-level topic area they aim to improve. Connected to the CARTBoard™, The Center for Case Management maintains a best practices library that aligns strategies and tactics for organizational improvement with the various CARTBoard™ functional areas and metrics. Additionally, The Center for Case Management has identified the most common and valuable datasets leveraged by organizations and included them in the CARTBoard™ data glossary to get organizations started with their Case Management dashboard development journey.
For more information on CARTBoard™ or assistance with your Case Management Dashboard, visit our website www.cfcm.com or contact The Center for Case Management at info@cfcm.com
About the Author:
Jeff Echternach is the founder and creator of CARTBoard™ and serves as Technology Officer for The Center for Case Management, an industry leading Case Management consulting firm recognized for custom development of tools, roles, and systems for managing outcome-driven care.
A fully integrated and effective case management dashboard is no easy task. It is one thing to put your top 25 metrics on a front page and color code them, but if we have learned anything from the discipline of Neuroscience, we know that’s a recipe for failure. According to David JP Phillips, the cognitive resources required to interpret data and react to information increases 5-fold when we place more than 6 key elements on a slide. Additionally various executives within the organization will view the data through a different lens. The same can be reasonably extrapolated for dashboard design. In order to deliver data in a manageable way, without creating fatigue, an effective summarizing system is needed that guides the user to true process or outcome variation. It is critical to have a standardized case management dashboard that is created to send a consistent message and allow the department to respond with an action plan.
The Center for Case Management has developed a suite of products that will enable Case Management departments to organize their data, identify areas of opportunity, and draw from a best practice library as they move from insight to action. CARTBoard™ is a vendor agnostic dashboard solution and data structure that can be adapted to your organizations data model. Here are some best practices that your organization should consider when investing in a Case Management Dashboard design.
Lesson 1: Getting Organized/Identify key data points
Human centered design should be at the center of your dashboard preparation. Data is not aggregated to a given page or set of visuals because of its existence in each module or portion of your IT Infrastructure, but instead, Metrics should be organized into functional areas that follow the workstream. The Center for Case Management identified four high level breakdowns that apply to all case management organizations, which include Clinical Case Management, Access Point Management, Revenue and Utilization, and Transitions. These summary areas created the basic model for CARTBoard™ and additional breakdowns are defined within each area.
Lesson 2: Develop an Effective Summary System
Striking a balance between the highest value metrics and a set of summary scores to communicate efficiency or outcome achievement is important. Case Management covers multiple areas and attempting to display all the key metrics for the department on one page, in a color-coded format is a distraction nightmare. Following the tenants of lesson 1, a structure enables logical order and organization for department leaders, and the use of a weight-based summary score for each ‘high level area’ properly draws focus and attention.
The Center for Case Management identified key measures that can be embedded in a summary scoring product that follows the four high level breakdowns: Clinical Case Management, Access Point Management, Revenue and Utilization, and Transitions. Much like a car’s dashboard, the summary system ties together high value visual trending graphics with a set of warning indicators to guide the user to key areas that should be examined.
Lesson 3: Create balance with Outcome Measures, Process measures, including data integrity and process efficiency
All too often, Dashboards and Data summary metrics for the Case Management department miss the overall narrative that weaves together a story, from process to outcome. Following the rules from the previous two lessons, the dashboard should move the user from a summary view to subsequent levels of detail. Within these detailed views, identify the narrative that links from process to outcome.
An important but sometimes forgotten attribute of process measurement, is process adherence and data integrity. Simplified means of monitoring for adherence to these processes, such as thorough assessment documentation (data capture), avoidable day capture, and appropriateness of UR review criteria set should be represented in process monitoring. CARTBoard™ leverages over 20 unique Case Management specific process and outcome metrics paired with a host of standard content metrics that are blended together to form a complete picture and identify opportunities.
Lesson 4: “No data have meaning apart from their context.” - Wheeler, 2009
Common mistakes made in dashboards today include compromising on space (visual real estate) and sacrificing the graph. Remember, “Two data points don’t make a trend” – Graban, 2019. When developing metrics, in summary form and expanding detail, ensure that you are escaping the cult of the average. Take Emergency Room Boarding times as an example. Let us say the organization set a goal that patients should board (or wait) no more than 4 hours. If we render an average of all emergency admissions and get a result of 3:44, is that success? What if, additionally, we look at the % of admissions that take > 4 hours and create a means of exploring the process elements (like the occupying unit, doctor, service, diagnosis, weekday, and other time factors).
It can be tempting to jump to conclusions or call a data tool ready for prime time. Ensure that your summary and associated details are prepared to support data exploration, and suppress ‘noise’ with process control charts, and other tools to address variation.
Lesson 5: Influencing Outcomes
A compelling dashboard is only part of the overall recipe. Organizations need to create dashboard tools that allow for interactive data exploration that offers logical data hierarchies and inter-connected fact pages so leaders can chase story lines and provide answers in a timely manner. Identifying the most meaningful data set to start with can be daunting, given the scope of coverage. When an improvement opportunity is identified or a regulatory reporting requirement is necessary, creating an action plan and implementing changes can be equally challenging. Teams often turn to literature and best practice papers to identify the ideal change solution, hopeful that the best solution was identified.
Linking back to lesson 1, the Case Management Department should have access to best practice libraries that align with the high-level topic area they aim to improve. Connected to the CARTBoard™, The Center for Case Management maintains a best practices library that aligns strategies and tactics for organizational improvement with the various CARTBoard™ functional areas and metrics. Additionally, The Center for Case Management has identified the most common and valuable datasets leveraged by organizations and included them in the CARTBoard™ data glossary to get organizations started with their Case Management dashboard development journey.