Measuring up

A balanced approach to performance at Brigham and Women's Hospital

Consistently named to US News and World Report's Honor Roll of America's best hospitals year after year, Brigham and Women's Hospital is a leader in the delivery of innovative and quality care. With 46,000 recent inpatient admissions, 3.5 million ambulatory visits, 59,000 ER cases and nearly 8,000 births, the hospital has a lot of numbers to track. And, for the institution's more than 20,000 employees – including physicians, nurses and researchers – quality and measurement form the fabric of the hospital's celebrated, and highly regarded, performance management culture. 

Customer Viewpoint

Troy Tomilonus 
Director, Decision Support System

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Since 2002, Brigham and Women's Hospital – a nonprofit teaching affiliate of Harvard Medical School – has been using SAS® Performance Management for health care to support a culture of data transparency, increased accountability and improved performance. By integrating, analyzing and distributing information to executive management, physicians and front-line management staff, SAS is helping hospital employees see how their actions, individually and as a whole, affect patient care, operational performance and the bottom line through a balanced scorecard approach to management.

Keeping score
With an executive-level focus on balanced performance in four strategic areas of the hospital –  service excellence and growth; quality and efficiency of care; commitment to people, research and teaching; and financial performance – the hospital’s performance management system comprises 200 scorecards that track hundreds of unique measures, such as length of stay, re-admission and mortality rates, patient satisfaction, market share and operating room efficiency.

Using SAS Performance Management for health care has allowed the hospital to embed scorecards, analytics and business intelligence into the fabric of the organization, providing executives and line managers with the information they need to make decisions.

The hospital has increased operating margins from $20 million to $100 million and improved patient satisfaction scores – moving from the 40th percentile, when it implemented a balanced scorecard, to the 90th percentile against academic teaching hospitals nationwide.

A balanced approach to management
As one of the first hospitals to pioneer a balanced scorecard approach to performance management, Brigham and Women’s Hospital – a member of the Balanced Scorecard Collaborative’s Hall of Fame and recipient of the National Quality Healthcare Award – is well out in front of other hospitals in terms of access to data and the ability to quickly deliver information to decision makers.

According to the Director of Decision Support Systems, Troy Tomilonus, the balanced scorecard plays a key role in the departmental planning and review process. For example, the hospital's regular quality committee meeting agenda is determined by the status of its quality scorecard, which tracks metrics such as mortality rates, surgical site infection rates and medication error rates.

 "We've developed an organization and a set of tools that allow us to quickly respond to the information needs of the hospital, while helping to change the delivery of care, reduce costs and improve the quality of care," explains Tomilonus. "Today, we have a better conversation around the four strategic areas than we did 10 years ago. The balanced scorecard has enabled us to make this change."

SAS allows staff outside of the Information Services team to develop and enhance the balanced scorecard with minimal IT support, which is crucial for an organization that has so many priorities competing for IT resources.

Real-time measurement
Recently, Tomilonus' team revamped the scorecard's dashboard interface, providing a real-time view of the hospital's census and occupancy data, which supports capacity management and resource allocation.

"Whether it's census and occupancy, admissions or surgical procedures, volume statistics are what people look at on a daily basis – they're the predictors of what revenue is going to be for that month," he explains. "Information is at their fingertips; instead of waiting days for data and reports, they can get them in moments."

As an extension of its performance management system, the hospital has added business intelligence tools for trend analysis on metrics such as length of stay. The information is used by the chief medical officer, division chiefs and staff to come up with programs or processes to optimize patient care.

"The value of SAS is its data access strength and the flexibility of its tools," concludes Tomilonus. "We've created a culture of data transparency, and the balanced scorecard is a focal point. The system has helped bring a strong focus on how employees do their work, without feeling limited by the lack of data and information."

The results illustrated in this article are specific to the particular situations, business models, data input, and computing environments described herein. Each SAS customer’s experience is unique based on business and technical variables and all statements must be considered non-typical. Actual savings, results, and performance characteristics will vary depending on individual customer configurations and conditions. SAS does not guarantee or represent that every customer will achieve similar results. The only warranties for SAS products and services are those that are set forth in the express warranty statements in the written agreement for such products and services. Nothing herein should be construed as constituting an additional warranty. Customers have shared their successes with SAS as part of an agreed-upon contractual exchange or project success summarization following a successful implementation of SAS software. Brand and product names are trademarks of their respective companies.

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