Hospital hones best practices

Brigham and Women's Hospital using SAS® to align all departments with strategy

Balanced Scorecard Hall of Fame for Executing Strategy 2006 National Quality Health Care Award 2005 SAS Ambassador Award for Healthcare

Brigham and Women's Hospital (BWH) in Boston is recognized throughout the world for excellence in patient care, in medical research and for training outstanding health professionals. But successful status quo is only a starting point: The hospital leadership is building on its strengths by using SAS Strategic Performance Management for Healthcare to implement and drive balanced scorecard initiatives on both the provider and business sides of the hospital.

Customer Success Video

Check out this video to learn more about Brigham and Women's Hospital and its successes with SAS.

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Sue Schade
Chief Information Officer

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Troy Tomilonus
Manager, Decision Support System

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"We wanted one-stop shopping, and we had a lot of different disparate reports, databases and one-off databases where various financial, quality and patient satisfaction information were housed," explains Sue Schade, the hospital's Chief Information Officer. "We wanted a quick and easy implementation, and we wanted something that did not take a lot of information systems time, because we had a whole host of other major initiatives on our plate."

With executive buy-in from the start, BWH chose SAS. "With SAS, we draw correlations between the different areas of the hospital and the different measurements to solve strategic problems as well as more day-to-day problems," Schade says.

BWH is a 755-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners Healthcare System, an integrated healthcare delivery network. The hospital cares for about 41,000 inpatients a year and more than 750,000 outpatients.

"There are huge workforce issues, particularly in areas such as nursing and in technical and specialty areas," explains Dr. Michael Gustafson, the hospital's Vice President of Clinical Excellence. "The public expects increased accountability to make sure that hospitals are providing quality care and safe environments. There is an increased demand among patients for better service from physicians. And patients are getting more involved; they have higher expectations when they come in for care."

Improvements through change
Successfully addressing these issues means integrating performance measures from the provider and business organizations to forge a single strategy for delivering the right set of services to the public. But without incorporating all relevant data, across-the-board improvement would be difficult at best.

"To make informed decisions, you need the data capabilities, and to drive change, you need accountability and incentives," Gustafson says. "When you put all of the management pieces in place, you have the ability to identify and implement real improvements."

Troy Tomilonus, Manager of Decision Support Systems

"Executive management might be using it to look at the overall patient satisfaction that we are reporting," Tomilonus says. "Physicians can look at their scorecard and see how they are performing. People at Brigham and Women's are very quality-focused and patient-focused. The balanced scorecard gives them a view of how they are providing that care and where to make adjustments."

For example, about 900 employees have access to a 30-metric hospital scorecard that is linked to key financial reports. "The idea is for them to see their area of performance as well as the overall big picture," Gustafson says. "That way, they can see how their activities relate to overall strategy and can adjust their goals accordingly. At the same time, they have a portal to some of our key reports dealing with patient satisfaction and length of stay. That information is penetrating into the organization much more than we've ever been able to do."

'It's literally no work'
Select physicians and nurses have their own scorecards so that they can share with their colleagues information relating to finance, productivity, workload and other quality indicators. Some department heads now routinely use the system to gauge hospital performance and have become adept at spotting monthly anomalies relating to length of stay or spikes in certain DRGs (diagnosis-related groups). "It's just a matter of logging in to the system, and it's all there," Gustafson says. "In the past, we'd have to do an ad hoc analysis and create each of those pieces from our internal systems, and now it's literally no work."

Quick and easy access to such information helps BWH staff identify patterns relating to delays in operating room (OR) start times so that physicians can alter their behaviors to reduce costs.

"If you have more cases starting on time in the morning, then your OR efficiency and productivity increase," Gustafson says. "Having more active review of our cost-per-case data allows our physicians to see the impact of some of the tests they order in a particular group of patients so that they can change that behavior. With SAS, we've built the infrastructure to drive strategy deeper throughout the organization."

SAS professionals lend expertise
SAS Consulting brought in the additional expertise needed to get the project in place so that the hospital staff could launch the solution to wide-scale success. "They worked very well with us to do the knowledge transfer and to get our people to the place where we could own the system and develop it further," Tomilonus says. "We've been able to roll this out to 900 people with minimal effort and with all of the training coming from our internal staff."

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