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Managing and Evaluating Rapid-Cycle Process Improvements as Vehicles for Hospital System Redesign: Table 2. Example of Rapid Improvement Event (RIE)-level metrics

DateDescriptionMetricsBaselineTargetFeb '06Mar '06Apr '06May '06Jun '06Jul '06Aug '06Total gross impactTotal net impact-softTotal net impact-hard
Operating room
June '05Surgical site infectionAntibiotic within 60 minutes of incision80%100%81%65%95%93%88%96%    
June '05Surgical site infectionAntibiotic discontinued within 24 hours of surgery end60%90%73%71%68%88%88%54%    
June '05OR schedulingUtilization of OR rooms 7:30AM-3:30PM66%85%69%69%72%70%70%68%75%   
June '05OR schedulingPercent of cases completed from 7AM-5PM daily76%80%74%78%81%77%80%77%79%   
June '05OR schedulingFirst case start on time17%50%25%33%26%31%35%35%31%   
July '05Pre-Op, PACU Phase 1 & 2Phase 1 & 2 standard work minutes per recovery210150141131131137123DNADNA   
Nov '05Eliminate errors in the OR/anesthesia professional and facility billing processFirst pass yield44%80%85%86%74%71%74%66%71%   
Dec '05Decrease non value-added time in the OR & anesthesia bill flow processCycle time (OR)5.6 days3.5 days1.81.72.42.62.32.71.7   

Financial Impact

Financial ImpactFeb '06Mar '06Apr '06May '06Jun '06Jul '06Aug '06Total gross impactTotal net impact-softTotal net impact-hard
OR hours1,3171,4961,3371,5491,4391,4071,561   
OR gross charges$5,160,786$5,389,995$5,015,603$5,706,218$5,979,332$5,253,271$5,710,276$1,879,122 $725,341
OR gross charges/or hour3,9193,6033,7513,6844,1543,7323,658   
OR overtime$12,258$15,897$17,026$16,760$9,323$10,600$12,004   
Anesthesia case hours2,2402,5592,4332,6762,7452,5412,873   
Anesthesiology gross charges$899,428$1,062,745$965,929$1,092,147$1,043,265$1,008,430$1,134,289   
Anesthesiology gross charges/case hour$401$415$397$408$380$397$395   
Anesthesiology overtime$311$224$794$502$141$224$248   
       Total$1,879,122$0$767,349

Note: Month/year in rows at left refers to date of RIE implementation; month/year in column headings refers to dates of followup. (Go to "Critical Lesson #8: Improving the Structure for Defining and Tracking Metrics" for further details on tracking guidelines.) Hard impact refers to the impact of the process change that is quantifiable and easy to calculate. It represents the actual benefit realized by the process change. Soft impact refers to the impact of the process change that is less quantifiable in which assumptions were necessary to translate the impact into a monetary benefit.
Key: OP = operation; OR = operating room; PACU = post-anesthesia care unit (recovery room).

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Current as of September 2007
Internet Citation: Managing and Evaluating Rapid-Cycle Process Improvements as Vehicles for Hospital System Redesign: Table 2. Example of Rapid Improvement Event (RIE)-level metrics. September 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/rapidcycle/rapidcycletab2.html