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-hardOperating roomJune '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 ImpactFinancial ImpactFeb '06Mar '06Apr '06May '06Jun '06Jul '06Aug '06Total gross impactTotal net impact-softTotal net impact-hardOR 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 $725,341OR 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$767,349Note: 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).Return to Document 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