Managing and Evaluating Rapid-Cycle Process Improvements as Vehicles for Hospital System Redesign: Table 2

Example of Rapid Improvement Event (RIE)-level metrics
Date Description Metrics Baseline Target Feb '06 Mar '06 Apr '06 May '06 Jun '06 Jul '06 Aug '06 Total gross impact Total net impact-soft Total net impact-hard
Operating room
June '05 Surgical site infection Antibiotic within 60 minutes of incision 80% 100% 81% 65% 95% 93% 88% 96%        
June '05 Surgical site infection Antibiotic discontinued within 24 hours of surgery end 60% 90% 73% 71% 68% 88% 88% 54%        
June '05 OR scheduling Utilization of OR rooms 7:30AM-3:30PM 66% 85% 69% 69% 72% 70% 70% 68% 75%      
June '05 OR scheduling Percent of cases completed from 7AM-5PM daily 76% 80% 74% 78% 81% 77% 80% 77% 79%      
June '05 OR scheduling First case start on time 17% 50% 25% 33% 26% 31% 35% 35% 31%      
July '05 Pre-Op, PACU Phase 1 & 2 Phase 1 & 2 standard work minutes per recovery 210 150 141 131 131 137 123 DNA DNA      
Nov '05 Eliminate errors in the OR/anesthesia professional and facility billing process First pass yield 44% 80% 85% 86% 74% 71% 74% 66% 71%      
Dec '05 Decrease non value-added time in the OR & anesthesia bill flow process Cycle time (OR) 5.6 days 3.5 days 1.8 1.7 2.4 2.6 2.3 2.7 1.7      

 

Financial Impact

 

Financial Impact Feb '06 Mar '06 Apr '06 May '06 Jun '06 Jul '06 Aug '06 Total gross impact Total net impact-soft Total net impact-hard
OR hours 1,317 1,496 1,337 1,549 1,439 1,407 1,561      
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 hour 3,919 3,603 3,751 3,684 4,154 3,732 3,658      
OR overtime $12,258 $15,897 $17,026 $16,760 $9,323 $10,600 $12,004      
Anesthesia case hours 2,240 2,559 2,433 2,676 2,745 2,541 2,873      
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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Page last reviewed August 2016
Internet Citation: Managing and Evaluating Rapid-Cycle Process Improvements as Vehicles for Hospital System Redesign: Table 2. Content last reviewed August 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/rapidcycle/rapidcycletab2.html