9 Ways Hospital Quality Teams Go Astray With Internal Dashboards and Tracking


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This article is part of the Dexur Insight, which is focused on Hospital Quality and Safety topics and is read by CEOs, CMOs, CNOs, CQOs, Quality, Safety, Compliance, Analytics & Performance teams. Please email dexurqualitysights@dexur5.com to join this newsletter and receive updates (not more than once per week).

Hospitals rely on internal quality dashboards to track various measures to improve in CMS Star Ratings, VBP, Leapfrog, HRRP, HACRP, and other programs. However, despite these efforts, several inherent challenges in the current systems can lead hospitals astray. Dexur offers an innovative solution by combining internal data with its proprietary data and utilizing best-in-class scoreboard tracking algorithms, presenting a more comprehensive and accurate picture of hospital quality.

  1. No Line of Sight to Out-of-Hospital Data:
    • Challenge: Hospitals often lack access to Out-of-Hospital data, leaving them blind to significant readmissions and mortality that occur outside of the Hospital Index stay. For instance, nearly 20-40% of Readmissions and 60% of deaths occur outside the Hospital Index stay.
    • How Dexur Does It: Dexur, an approved purchaser of CMS Medicare claims data, can provide valuable insights into the full patient journey, bridging this critical data gap.
  2. Complexity in Risk Adjustment:
    • Challenge: CMS Risk adjustment algorithms are complex and require consistent monitoring, a hurdle for hospitals striving to stay on top of them.
    • How Dexur Does It: Dexur’s advanced risk adjustment algorithms facilitate the comparison of observed and risk-adjusted rates, enabling more accurate assessments.
  3. Deciphering Multiple Data Elements:
    • Challenge: In the ever-evolving healthcare landscape, hospitals find themselves in a complex and intricate position when trying to decipher what different data elements signify about a specific measure, akin to solving a Rubik's Cube. Take, for instance, the measure of Heart Failure Readmissions. This measure exists in various forms, including In-Hospital data (which lacks access to Out-of-Hospital data), external full patient journey data provided by vendors like Dexur, forecasted risk-adjusted data, and the final CMS measure. The multifaceted nature of such data poses a significant challenge for hospitals, as their dashboard technology often struggles to integrate and make sense of all these different data versions.
    • How Dexur Does It: Addressing this, Dexur brings to the table its best-in-class scorecards and measure tracking system featuring a concept known as "Data Classes." This innovative approach enables the comparison of a measure's different versions across time, illuminating consistencies and discrepancies among each data class. By providing a more holistic and integrated view of data, Dexur ensures that hospitals are not taken aback by the final measures, thereby aiding them in making more informed and strategic decisions for quality improvement.
  4. Incorrectly Configured Goals:
    • Challenge: Hospitals often struggle with setting the right goals, as they lack knowledge of the appropriate benchmarks and percentiles.
    • How Dexur Does It: Dexur provides benchmarks at the 10th/30th/50th/70th/90th percentiles based on its proprietary data and national data. Furthermore, goals are aligned with AI-driven simulations to ensure continuous improvement in quality programs.
  5. Issues with Data Granularity:
    • Challenge: Many hospitals track data monthly, which, due to low denominators, can be spiky and fail to give clear trends.
    • How Dexur Does It: Dexur offers rolling time periods at various intervals, including yearly and every 3 years, aligning with CMS program reporting periods to highlight clear trends over time.
  6. Lack of Context into Interventions:
    • Challenge: Hospitals frequently implement interventions without having insights into how these interventions are impacting measures.
    • How Dexur Does It: Dexur’s intervention tracking is closely tied to measures and scoreboards, effectively showcasing the impact of different interventions.
  7. Data Abundance, Insight Scarcity:
    • Challenge: Hospital teams are inundated with data, but there is often a lack of automated insights to guide focus on pivotal areas.
    • How Dexur Does It: Dexur’s AI Advisor automatically sifts through all measures to provide early warning alerts, trend changes, and essential insights.
  8. Isolation in Measure Tracking:
    • Challenge: Hospitals may track measures like Standardized Infection Ratios (SIRs) in isolation, unaware of how these measures collectively impact program scores such as CMS Star Rating or Leapfrog.
    • How Dexur Does It: Dexur not only tracks internal HAI data sourced from CDC’s NHSN but also elucidates the collective program impact of these measures.
  9. Limited Forecasting Ability:
    • Challenge: Hospitals usually have a snapshot in time regarding current data but struggle to forecast measure scores 1-3 years into the future.
    • How Dexur Does It: Dexur excels in forecasting, enabling hospitals to predict their performance on various measures in the coming years.

In conclusion, while internal hospital tracking presents a myriad of challenges, from deciphering multifaceted data elements to forecasting future performance, solutions like those offered by Dexur are playing a crucial role in addressing these issues. Integrating varied data and providing comprehensive insights are imperative for hospitals aiming to improve quality programs and deliver enhanced patient care.