How Can Hospital Performance Be Measured and Monitored? Research Paper Example

Introduction

The below case study will focus on the effectiveness of the New York Presbyterian Hospital Network based on the below question: how prepared the network is to address the health needs of the population served by its hospitals. The main assessment criterion will be derived from similar academic case studies focusing on health care delivery efficiency, patient outcomes, cost-effectiveness, and the implementation of evidence-based practice.

Background Information

The New York Presbyterian Hospital Network has 26 hospitals, and was ranked the 5th largest Health Care Network in the United States in 2010 (Dark Daily, 2010). The network offers a wide range of services, from rehabilitation medicine to children’s health (NYP.org, n.d.). It was ranked number one in the New York metro area by the US. News and World Report. There are 2508 certified inpatient hospital beds, and 2328 staffed beds in all hospitals managed by the network. One of the main mission statements of the hospital network state that the health care network is “ committed to serving our community and ensuring that all of our state-of-the-art programs are within everyone’s reach” (NYP.org, n.d.). Therefore, access to all, and serving disadvantaged populations should be in the focus of the provider. The below analysis of processes, performance measures, and patient outcomes will determine whether or not the hospitals managed by the provider are able to deliver the above promise.

Organizational Assessment

Determining Measures

According to a recent WHO Report (Shaw, 2003), there are some proven to be effective quality indicators that can be applied for assessing health care organizations’ performance against targets, public expectation, and government benchmarks. The authors of the study identify statistical data, patient surveys, and independent third party assessments the most suitable for measuring performance.

Ioan, Nestian, and Tita. (2012) highlighted the importance of using key performance indicators (KPI-s) when measuring hospital and health care network effectiveness. According to the authors performance is “the extent to which set objectives are accomplished” (p. 2).

The main dimensions the authors identify related to health care management are clinical efficiency, production efficiency, personnel, social accountability, safety, and focus on patient (patient-centered care). Therefore, the above criterion and measures will be assessed, based on the yearly report and publications of the New York Presbyterian Hospital Network.

Clinical Efficiency

Clinical efficiency can be measured by patient outcomes and the quality of health care. Several indicators  published on the New York Presbyterian Hospital Network website (n.d.) indicate that the clinical efficiency of the network is high. As the website confirms: “more physicians from NewYork-Presbyterian were named to America’s Top Doctors than from any other hospital in the nation” in the Top Doctors Magazine.

Production Efficiency

The 2010 Annual Report (Nyp.org, 2010). In 2009, 110.466 patients were discharged from the 26 hospitals, compared with 107.283 in 2008. The hospital performed over 28.000 surgeries, and carried out 67,196 ambulatory and outpatient surgeries. This indicates that production efficiency and service within the New York Presbyterian Hospital Network’s hospitals is great, and the clinicians and nursing staff maximize the opportunities for helping their patients.

Personnel

As it has been stated before, the clinicians of the hospitals belonging to the network are widely recognized by health care organizations and independent agencies. To improve the level of service and respond to the increasing volume of patients seeking medical help (NYP Annual  Report, 2010), the network is expanding its technical and personnel capabilities. Based on certifications, experience, and disciplinary history, the doctors of the network are among the best in the country (Nyp.org, n.d.). There are a total number of 6,780 physicians working in the hospital network. (Nyp.org, n.d.).

Social Accountability

This measure is usually assessed based on the level of service provided for disadvantaged populations. In the health care system, the most disadvantaged populations are those without insurance, and those who are critically ill. According to the website of the organization, the hospital spent a total of $105.7 Million on charity care in 2014. A recent Community Needs Assessment report (Health New York, 2014) has found that in the community served by the New York Presbyterian Hospital Network the most common causes of death are diseases of the heart, and cancer (Health New York, 2014). The main health risk factors associated with chronic diseases are obesity, smoking, and heavy drinking. Other high prevalence diseases in the region include cholesterol abnormality, hypertension, low back pain, depression, and diabetes. Among children, asthma, vision and hearing problems, as well as developmental delay are among the most common health -related conditions. In order to assess the hospitals’ social accountability, it is also important to review some the community health plans of the network.

The Community Service Plan of  2013 (NYP, 2013) shows that two priority areas have been selected for the next years that the leadership of the hospital network would like to focus on: chronic disease prevention and mental health promotion, including substance abuse prevention. As it has been noted above, diabetes and obesity have a high prevalence rate within the community served by the hospitals, and alcohol abuse is one of the main causes of chronic illnesses. The mission and  strategy of the NYP network is, therefore, aligned with the community’s needs. One of the goals set by the report is to “Develop screening protocols, risk stratification and tracking systems for patients with diabetes, asthma, heart failure and depression at all NYP/Columbia” (NYP, 2013), and creating a depression registry is also included in the list of initiatives.

Patient-Centered Care

One of the most important criterion for the Top Doctors Magazine was patient care, as the New York Presbyterian Hospital Network website (n.d.) states. This indicates that the organization is able to serve the health needs of the population. The main focus areas of the hospital network, based on the 2013 Community Service Plan (NYP, 2013) are:

• depression screening implementation
• creating a registry for children with special care needs
• planning an adult obesity full spectrum program that integrates prevention, medical, and surgical interventions
• creating an asthma registry
• and to “Obtain NCQA Level 3 PCMH Certification (2011) for all 7 ACN Clinics. Focus and provide panel management, and self-management support on diabetes, asthma and CHF” (NYP, 2013 p. 7.)

Findings

Based on the above analysis, and the comparison of the hospital network’s strategy initiatives with the needs of the community, it is evident that the leadership tailors health care intervention and prevention initiatives to the needs of the large population served by the 26 hospitals.

Conclusion

Overall, it has been found that the New York Presbyterian Hospital Network has scored high in clinical efficiency, social accountability, and community (patient centered care) approaches. The organization closely monitors at-risk populations’ needs, and responds to risks by developing effective prevention and intervention programs. The several community health awareness programs and initiatives developed by the hospital, as well as detailed treatment protocols for the most prevalent conditions, such as depression and diabetes have been introduced to increase the network’s efficiency to serve the health needs of the community. Therefore, the New York Presbyterian Hospital Network has been found effective and responsive to patient needs.

References

Shaw, C. (2003). How can hospital performance be measured and monitored?. World Health Organization Regional Office for Europe.

Dark Daily (2010) Ranking the Nation’s 25 Largest Healthcare Systems by Employees. Retrieved from  http://www.darkdaily.com/ranking-the-nations-25-largest-healthcare- systems-by-employees-825#axzz3rO4wpq2v

Health New York (2014) Community Needs Assessment New York State Delivery System   Reform Incentive Payment (DSRIP) Program. Retrieved from https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/pps_applications/docs/the_new_york_and_presbyterian_hospital/3.8_new_york_presbyterian_hosp_cna2.pdf

Ioan, B., Nestian, A. S., & Ti??, S. M. (2012). Relevance of key performance indicators (KPIs) in a hospital performance management model. Journal of Eastern Europ Research in Business & Economics. 1, 15.

New York Presbyterian Hospital Network (2013) Community Service Plans. Retrieved from http://nyp.org/about/community-service-plans.html

New York Presbyterian Hospital Network (n.d.) Website. Retrieved from http://nyp.org/