WebFOCUS PMF Drives a Performance-Oriented Culture at Maasstad Hospital

KPIs and Dashboards Provide Key Healthcare Metrics to Managers, Physicians, and Administrators

For Maasstad Hospital in Rotterdam, the need for growth, healthcare benchmarking, and pay-for-performance services have put business intelligence (BI) in the spotlight. Decision-makers at the 600-bed facility rely on metrics from Information Builders WebFOCUS Performance Management Framework (PMF) to drive many aspects of their business. Maasstad is an ambitious organization, competing with six other major hospitals in the region and constantly striving to provide quality care at a reasonable price point.

Its efforts are not without precedent. The Netherlands has led the world in increasing accountability and reducing healthcare costs over the last four decades. Fees for care are regulated, as is the spread of hospital buildings. Since the end of the 1990s, the country has put forth various initiatives to make a shift from supply regulation to a customer demand-driven system (see sidebar, Accounting for Care).

"No matter how healthcare is regulated, we must perform within our strategy to provide the best care at the lowest cost," explains Henri de Wit, manager of finance and business intelligence at Maasstad Hospital. "Strategic tools like PMF help us meet our goals. We want to have satisfied patients as well as satisfied employees, so we are using this performance management technology to help us benchmark all our critical processes to create our own set of standards."

A Cure for Ailing Information Systems

In 2007, de Wit and his team responded to reforms in hospital care and government initiatives by developing key performance indicators (KPIs) for four domains of the business: customer satisfaction, quality of care, costs, and market share. Within those four domains, they developed KPIs for technical and operational goals. However, they had difficulty presenting the information to key stakeholders. Maasstad had been using the ChipSoft healthcare information system, but found it to be lacking in business reporting capabilities.

"We wanted to be able to display KPIs in a way that was easy for management to understand and make use of," de Wit says. "Our board chose WebFOCUS PMF because it is easy to setup and use. It works with any system, so we knew we would be able to leverage all of our information and fast-track the implementation."

For example, instead of requiring a lengthy extract, transform, and load (ETL) project to acquire metrics and dimensions, PMF includes a simple wizard and scheduling system to set up the back-end data environment. And instead of requiring developers to create individual scorecards, dashboards, and roles for every user, PMF provides templates and parameter-driven tools, which let the data drive a rich set of reporting functions. PMF can access more than 300 data and application sources. It is also easy to integrate with existing applications, portals, and databases. This ensures that Maasstad can easily monitor and manage any metric, no matter where it is stored or in what type of application it originated.

Putting Performance Metrics on the Examining Table

The BI team at Maasstad is now using Information Builders' turnkey performance management platform to capture more than 100 industry-specific KPIs and present them to the board, managers, and clinicians via secure, customizable dashboards. Users can personalize the dashboard environment by deciding which reports they wish to see and how they want them to be displayed. They can also use PMF's built-in analytic tools to create or modify unique reports and graphs.

"WebFOCUS PMF was easy to get up and running quickly," de Wit says. "It is designed to quickly capture metrics and deploy dashboards."

PMF includes pre-set roles for analysts, administrators, and consumers of information. It also features more than 100 reports and graphs, hundreds of pre-built metric rules, and a variety of dashboards. In Maasstad's case, the performance information comes from a diverse set of sources. A ChipSoft transaction system gathers information from radiology, dialysis, administration, pharmacy, salary, financials, and other business domains. This information is loaded into a Microsoft SQL Server data warehouse, which serves as a staging point for delivering current information to the performance management system.

Armed with this information, Maasstad uses a dual-management system, which places responsibility on the shoulders of both administrators and clinicians. WebFOCUS PMF enforces this management strategy with targeted dashboards for each administrator, nurse, and doctor in charge of delivering quality care. "There are dashboards for our supervisory council, board of directors, and middle management," de Wit explains. "Using PMF, these people can steer the performance of the hospital."

Managers in the four domains of the business receive information daily, weekly, and monthly from WebFOCUS PMF. They simply review the appropriate dashboard to see how their department is performing.

"Each department is held accountable to a set of daily metrics, encouraging a culture of performance and achievement," de Wit adds. "Over time, not only does the organization become more efficient, but we can also develop a set of best practices for the administrators and doctors. They are gauged by their work in comparison to their peers.

Diagnosing Patient Satisfaction Levels

According to de Wit, many hospitals share KPIs with one another. "Even though we are in competition on a regional level, we share metrics on a national level," he notes. "There is a value chain of metrics in our industry. The lowest level concerns the metrics that hospitals are required to report to comply with regulations; the next level is when hospitals use the metrics to run their business; and the top level is when they use it as an asset or a marketing tool for their company."

For people in need of care, the benefits are clear. De Wit explains: "WebFOCUS provides transparency into what we do, how we do it, and what it costs, so patients have a better understanding of the quality of care they will receive."

Along with metrics for doctors and administrators, the hospital is also measuring patient satisfaction. Based on patient interviews, Maasstad creates a Net Promoter score, which gauges its reputation and progress within its industry.

"Our goal is an 80 percent Net Promoter score," de Wit reveals. "Changes in that score occur slowly, so you have to perform very well. WebFOCUS PMF provides us with a definitive look at our performance so we can make the changes necessary to constantly improve our quality of care and level of patient satisfaction."

It's a process of continuous improvement: managers learn from each KPI and can use that knowledge to develop and refine other types of quality control indicators.

"KPIs are really the only way to measure business and hold people accountable for certain targets," de Wit says. "Because of our ambition and strategic goals, this is very important. Thanks to WebFOCUS PMF, we are proud to say we have a performance culture at Maasstad. We're on the cutting edge of that development in Holland."