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PMBonusCaseStudy3.docxAssignment: Review the information below and write a 1/2 to 1 page summary on the benefits of utilizing the SMART concept for writing goals.
How to Write a Better Outcome or Process Goal
(Curt Selike)
For a measure to be transformed into goal it needs to be SMART : specific, measurable, attainable, relevant, and timely. Science tells us that people who write goals are significantly more likely to accomplish them. In a study of students in the Harvard MBA program , only three percent had written goals and included plans to accomplish them once they graduated. Ten years later, those three percent who had written down their goals were now earning 10 times more than the other 97 percent of their class combined. So remember to be SMART in writing down your goals.
See Figure 1 below.
How to Obtain Baseline Data – the “X”
In order to write SMART goals, clinical improvement teams require baseline data (the “x”). Baseline data provides insight into the current-state and establishes a starting point to measure against once improvement efforts have begun. Baseline data can also be used for motivational purposes after the work has started to remind team members how far they have come and to realize that their hard work is indeed making a difference.
Before beginning improvement work, both healthcare leaders and clinicians frequently look to gather information in order to understand historical trends and the necessity behind the need for change. If expert clinicians are involved in the work, and have been seated at the table early, often their expertise can be utilized in confirming initial directions and identifying processes that require attention. These insights may not be summarized quantitatively however, this qualitative data is just as rich and frequently can be leveraged in preventing project delays and in facilitating widespread adoption. The benefit in having an enterprise data warehouse (EDW), is that once a measure is defined, a baseline value can be established at a later point, when the data becomes available. The data can then be used to validate the consensus of the team.
How to Determine the “To” Goal – the “Y”
The “y” component of a good goal, be it a process or outcome, allows for identifying a desired level of performance. A good “to” goal should be ambitious, but realistic in order to promote change, deliver improvements in quality, productivity, and efficiency, and, in turn, bring innovation.
Internal vs. External Benchmarks
In order to set a “to” goal, an improvement team needs to understand why they are setting the target. Understanding the why, will likely inform the team on whether to use internal or external benchmark target(s) (using a tool such as Touchstone™). There are specific advantages and disadvantages to each.
Internal benchmarks compare performance within an organization, department, or service line.
Advantages to using internal benchmarks include:
· Stakeholders who share a common culture and systems.
· Access of data leveraging standard definitions.
· Access to people doing the work in various (facilities, departments and roles)
Disadvantages of internal benchmarking include:
· Information can be limited in scope.
· Inability to see relative degree of performance to that of local, regional and national trends
External benchmarks compare performance measures with other organizations or against data published in the literature. The advantage to using external benchmarks is that it can provide an opportunity to learn from other experts from across the industry. But, there are a number of disadvantages to keep in mind:
· Unrealistic expectations – It could result in unrealistic goal setting and disappointment if the goal is not met.
· Infrequent reporting – Some external benchmarks (such as NHSN) are not reported frequently enough for feedback to the improvement team.
· Lack of data transparency – There is intentional variation across the country in care practices as populations differ. Organizations are also at varying degrees of improvement practices. Be cautious in looking at a number without understanding what the number actually entails and how that number came to be. Remember that numbers are often a representation of unique individuals or populations that have been influenced as a result of multiple processes.
Ultimately, teams need to weigh the advantages and disadvantages and determine what measurement is best for them in setting their goal.
Questions and Answers for Effective Outcome and Process Goals
Setting clearly defined, strategically aligned goals is a critical part of a successful clinical data analytics strategy and a necessity for outcomes improvement. While it can be difficult for health systems to do effectively, clear goals are an important part of change management.
Below are some questions to ask when setting goals that will help tell a complete story and increase buy-in:
1. Are observed differences due to differences in the type of patient cared for in different hospitals (i.e. age, gender, comorbidity)?
2. Are there differences in the way the data is collected?
3. Are there “due to chance” differences?
4. Are there outlier impacts ?
5. Do differences reflect real, although unobservable, differences in quality of care?
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