Measuring the quality of services and the effectiveness of strategic management is fundamental for the survival and continued growth of hospitals. Through indicators, which are nothing more than tools for evaluating the organization's performance based on pre-established criteria and goals, it is possible to identify bottlenecks and the institution's competitive advantages.

The data collected in the hospital environment, when crossed and interpreted, become a useful tool for evaluating the conscious use of resources, end-customer satisfaction, the quality of services provided, and the degree of strategic management maturity. These statistics are fundamental for planning and preventing non-conformities.

The construction of an indicator can be simple, with a mere count of cases, and can be complex with sophisticated calculations of proportions, ratios, and indexes. The complexity will vary according to the established goals and the organization's capacity to collect concrete data. When creating indicators, it is important to define the indicator's name, how it is calculated, its type (rate, coefficient, absolute number), the responsible party, the information source, measurement frequency, and the monitoring objective.

Thinking about what defines a hospital's success is a good starting point for defining goals and indicators. According to Fraciele Fucks, corporate education administrator at Hospital Itaiguapy, what defines a hospital's success is “having managers directly involved in the strategy, from the board to the employees, so that everyone works together to achieve the goals.” Nicola Giancristofaro, administrative-financial director of the Perinatal group, believes that a hospital's success lies in the satisfaction of those involved, that is, patients, partners, and employees.

The essential indicators

Indicators can vary depending on the size of the institution, its specificity (maternity wards or day hospitals, for example), whether it is private or public, among other variations. However, there are some indicators that are essential, as they evaluate basic metrics of most hospital organizations. They are:

Hospital occupancy rate

This indicator shows the percentage relationship between the number of patients per day and the number of beds per day over a specific period. However, for the calculation of beds per day, installed and constant beds registered with the hospital are considered, including blocked beds and excluding extra beds.

Patient-Day Count
————————————————– x 100
Number of patient-days

If the hospital constantly uses extra beds, the hospital bed occupancy rate can go above 100%, which is important information from a management perspective.

In this calculation, observation beds, post-anesthesia recovery or post-operative beds, healthy newborn cribs, pre-delivery beds, and beds blocked for transient reasons (characteristics of other patients occupying the same room or ward, building or property maintenance, temporary staff shortage*) are not considered.

Average length of stay

With this indicator, it is possible to measure the relationship between the total number of patients per day and the total number of patients discharged from the hospital in a given period, including deaths. In other words, it represents the average number of days patients stayed in the hospital.

Patient/Day number, during a specific period
—————————————————————————–
Number of patients discharged in the same period

It is important to note that this formula should only be used for hospitals with short-stay inpatients. For long-stay hospitals, the sum of the days of hospitalization for each patient discharged or deceased should be used in the numerator. Furthermore, the calculation of this indicator can be affected by internal transfers. To avoid duplication of admissions or splitting of patient stays, the entire length of stay must be attributed to the unit from which the patient was discharged. For each unit (such as the ICU, for example), statistics should be compiled separately, including all patients who passed through the unit.

Hospital-acquired infection

Hospital-acquired infection is one acquired in the hospital that was neither present nor incubating at the time of the patient's admission. It can manifest during hospitalization or even after discharge. Currently, the term hospital-acquired infection is being replaced by “Healthcare-Associated Infection” (HAI). This includes outpatient clinics, home care, and infections acquired by hospital staff.

Hospital-acquired infection rate (%):

number of hospital-acquired infections
—————————————————
number of exits

Hospital Mortality

This indicator monitors the percentage relationship between the number of deaths that occurred in inpatients during a given period and the number of discharged patients.

Number of deaths in a given period
—————————————————— x 100
Number of outputs in the same period

Re-entry and Re-admission within 30 days

Assessing whether patients return or are readmitted within a short period is important for defining the quality of services provided by the hospital. This indicator calculates the percentage ratio between the number of unscheduled readmissions for the same or an associated cause within 30 days of hospital discharge and the total number of discharges.

Number of unplanned readmissions within 30 days of hospital discharge
—————————————————— x 100
Total outputs

Evaluating these indicators provides a global view of service quality and potential crises, allowing them to be averted in time. A hospital-acquired infection outbreak, for example, can be prevented by closely monitoring this indicator.

According to Franciele Fucks, Hospital Itaiguapy conducts monthly follow-ups with each area, evaluating operational, strategic, human resources, and financial indicators. They have been using the software since 2014. Strategy Management “since then we have all the data at our fingertips. Everyone has centralized information, it's more practical, more real. Before, everything was in spreadsheets and it was difficult to gather all the information for a global analysis. Today, we have our entire strategic plan within the software,” she says.

See also “5 reasons to avoid using spreadsheets in management”

For Nicola Giancristofaro, GE software also greatly aids in managing the more than 300 indicators that make up the Aliança Hospital's strategic map. They have been using the system since 2008, and before that, all management was done in Excel. “The advantage is that the software pulls data directly from the ERP and provides it in the form of information. When you have a result, you can drill down to the operational level. This avoids many errors,” he comments.

Get to know the software better Strategy Management and see how it can assist in managing your hospital.

See also: “Hospital management campaign is a success”and get to know the campaign we created for hospitals that serve the SUS.

Sources: CQH and the “Hospital Indicators” blog”