Triple Impact Quickscan

12 may 2021

The Triple Impact Quickscan makes it possible to identify and analyse the bottlenecks indicated in the 3M portal, and to quickly work towards improvements.

Context and Approach

For nearly 20 years, 3M has worked closely together with Belgian hospitals to provide objective comparisons for Minimum Hospital Data (MZG/RHM) and other hospital data, often in the form of benchmarks.

Through this long-standing relationship, 3M now represents over 65% of the Belgian hospital beds, and most hospitals use one or more of their benchmark modules. However, many hospitals have insufficient capacity in their data management and hospital information divisions to thoroughly analyse such amounts of data.

Hict provided a global evaluation of the available hospital information for one of its clients by applying a Quickscan-approach. By applying the Quickscan methodology, the total time for the analysis was reduced to a maximum of 4 weeks, which allowed the hospital to start using these results on a very short term.

By using a layered approach, impact is created on three different levels (Triple Impact) of the organisation.

TRIPLE IMPACT

Level 3 is the strategic level, on which the physicians or the management use the indicators from the 3M portal to steer the organisation on aspects such as quality, length of stay, etc.
Level 2 is the operational level, in which the causes of the bottlenecks are analysed. A bottleneck is usually traceable to one of the following causes: (1) Encoding, (2) Reporting or (3) the Clinical Process itself.
Level 1 is the impact on the quality of the data. During a Quickscan analysis, data quality is assessed by looking at the following encoded elements: present on admission, share of SOI-1, exhaustivity of coding, etc.

OBJECTIVES OF THE CLIENT

The hospital wants to use the quality indicators of the 3M portal (the Quality Square, see image 2) as a quality instrument, while avoiding an extra burden of registration for its physicians.

The Quality Square consists of 4 indicators:

SMR: Standardized Mortality Rate
PPC: Potentially Preventable Complications
PPR: Potentially Preventable Readmission
JLOS: Justified Length of Stay

Hict was asked to provide a validation and an analysis for two medical specialisms on:

Linking the 3M service line with the medical specialism, so only the files from the chosen specialism will be used in the analysis
Performing the Triple Impact Quickscan analysis on the three indicated levels (see image 1)
1. Level 1: Data quality: assessing the quality of encoding of the selected files
2. Level 2: Operational quality
  1. Validation of the files using a validated instrument (no false positive files in the selection)
  2. Root Cause Analysis of the SMR, PPC and PPR files so operational actions can be taken to improve the results
3. Level 3: Validation of the indicators so they are usable as an instrument to steer on clinical quality for specific medical specialisms.

Results

The hospital was, based on the protocol, capable of connecting the 3M service line to the medical specialism as organised within the hospital.
There was a 100% match between the dossiers and the indicators (SMR, PPC and PPR) from the Quality Square (= level 1: Data quality).
The Root Cause analysis of the files immediately provided the hospital concrete elements of improvement (=level 2: Operational impact)
Due to no detected false positive files, the Quality Square indicators are usable as a clinical quality indicator (=level 3: Strategic impact), without extra burden of registration for the physicians.