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Get on board managing with metrics, or give somebody else a chance

July 10th, 2014

by Lynn McVey

Six months ago, when my dad needed an emergency pacemaker, I wrote about the lack of care coordination I witnessed as an insider. Because I am an insider, I was able to navigate him through three hospitals for three life-saving interventions in three days. As the acting CEO of a hospital, I intercepted two preventable medical errors on my father's behalf. Nearly 30 caregivers walked into his room every evening/night.

At this point, we (the healthcare industry) aren't even close to solving this dilemma. We haven't even come up with a concept to link all these interventions to prevent redundancies and errors. I read today that the most likely disrupter, who might fix our current healthcare system, will probably come from a different industry. Who is healthcare's Steve Jobs or Jeff Bezos?


It is my hope and wish that the data analytics trend will gain much more momentum. With reimbursement changes coming faster and faster, healthcare leaders realize they need better intelligence on financial, operational and clinical issues across the enterprise. At Healthcare Financial Management Association's (HFMA) most recent conference, most attendees realized they need an internal data warehouse for reporting.

I say this is still not the answer. What we actually need is external warehouses for all 5,000 hospital departments. Radiology needs a performance clinical and financial warehouse. Nursing needs a performance clinical and financial warehouse. Pharmacy needs a performance clinical and financial warehouse. The lab needs a clinical performance and financial warehouse. You see where I'm going. There is no reason to continue spewing "hospitals are unique" any longer. That excuse is tired, weak and quite frankly--lazy.

The sad part is hospitals have hidden behind "we are unique" for so long, that it is nearly impossible to gain consensus on what standards to measure. Actually, hospital leaders haven't had to do much changing at all in the last 50 years. And since we haven't managed with a national database of metrics and benchmarks, we do not know how anyone's performance will rank. How will the CEO react when they learn they have the most expensively run emergency room in the country? Will they find out their nursery is staffed two times higher than the national median? What if they discover their overtime or absenteeism rate is four times greater than all other hospitals? Only one thing is sure, until we have a national database of six overarching performance indicators, hospitals will remain in the dark.

Managing with data analytics is an extreme disruption to hospital leaders who for decades, managed with opinion, emotions and bias. I don't know about you, but I continually cringe when I hear about some of the embarrassing errors we make. It doesn't have to be like this. There is a new urgency to manage with analytics and I implore everyone to get on board.

Due to years of non-evidence-based decision making, we wasted billions and billions of healthcare dollars. We are left with a system that is too complex, too complicated and years away from being fixed.

A wise NYU Professor, Anthony Kovner said, "There is tremendous amount of literature describing hospital closures, bankruptcies, mergers and quick unmerges, which leads one to conclude there may not be much evidence going into healthcare decisions."

My dad, John F. Rhatigan, died July 2. In the end, it was only because I was an insider that he died peacefully and on his terms.

Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey.


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