Here are 16 typical hospital business process KPIs in two categories,

according to the whitepaper:

Inpatient flow
1. Inpatient raw mortality rate
2. CMS core measures
3. Harm events per 1,000 patient days
4. Bed turnover
5. Readmission rate
6. Occupancy rate
7. Average length of stay
8. Average cost per discharge
9. Patient satisfaction
Revenue cycle
10. Total operating margin
11. A/R days due to coding
12. Total A/R days outstanding
13. Total A/P days outstanding
14. Cash receipt to bad debt
15. Claims denial rate
16. Days of cash on hand
4. 25 Healthcare Metrics & KPIs
Operations
1. Patient Wait Time: Calculates the average amount of time a patient
must wait between checking in and seeing a provider. This can help
with staffing and scheduling and provide insight into patient
satisfaction.
2. Average Number Of Patient Rooms In Use At One Time: Shows
how well space is used to treat patients and helps determine if more or
less space is needed in the facility. Think about this as an occupancy
rate, like at a hotel.
3. Staff-To-Patient Ratio: Indicates the use and capacity of staff
resources, which can affect the quality of patient care.
5. Bed Or Room Turnover: Demonstrates how fast patients are moving
in and out of the facility. This affects the efficiency of the facility and
should be considered when looking at patient satisfaction. You might
want to consider tying this one closely with readmittance rates to
make sure you that you are not letting people leave the facility who are
not well.

5. Communication Between Primary Care Physician,

Proceduralist, & Patient: Determines how frequently various parties
are in communication with one another, increasing the quality of care
for the patient. This is sometimes measured by satisfaction, and
sometimes measured by the number of documented communication
activities.
Finance
6. Average Insurance Claim Processing Time & Cost: Averages the
amount of time and money an organization spends processing
insurance claims. When low, it indicates that the facility receives
payment faster and there is less cost to the patient.
7. Claims Denial Rate: Provides insight into the effectiveness of the
organizations revenue cycle. A low claims denial rate means that the
organization has more time to focus on patient care and spends less
time on paperwork.
8. Average Treatment Charge: Shows the average amount that a
facility charges a patient for a treatment. It can be broken down by
treatment or shown as an average of all treatments or treatment
categories.
9. Permanent Employee Wages: Records the value of wages (including
bonuses) paid to all full-time employees during the reporting period.
This is sometimes separated out by administration, and sometimes by
direct providers of care.
Communications
10.Number Of Media Mentions: Keeps track of how often youre
mentioned in the media, which could include news outlets as well as
social media. You may want to consider tracking positive and negative
mentions separately.
11.Overall Patient Satisfaction: Calculates satisfaction levels by
combining several factors. This can be a great marketing tool for your
organization if its high, but a low number could signal a problem with
other operations or services.
12.Percentage of Patients Who Found Paperwork To Be Clearly
Written & Straightforward: Demonstrates whether a healthcare
organization has ensured that written materials have clear instructions
that patients can understand easily and respond to.
Internal

13.Trainings Per Department: Tracks the amount of training each

department provides or requires of their staff.
14.Number Of Mistake Events: Measures the number of mistakes made
in the organization, which can be tracked by mistake category. This can
indicate the effectiveness of the employees and the equipment.
15.Patient Confidentiality: Measures the number of times a patients
confidential medical records were compromised or seen by an
unapproved party.
16.Number Of Partnerships With Advocacy Groups: Counts the
number of relationships established with other organizations. A high
number of partnerships can increase the impact of campaigns and
policy events.
Public Health
17.Childhood Immunizations: Demonstrates the number of children
who have received immunizations, which reflects your contribution to
overall community health.
18.Number Of Educational Programs: Indicates the time and effort put
into educating the public. This can be broken down into the type of
program as well as the target audience for each program.
19.Number Of Preterm Births: Counts the number of preterm births
(under 37 weeks) that have occurred in the region.
Emergency
20.Patient Wait Times By Process Step: Shows the amount of time a
patient must wait during their visit to the emergency area of the
facility.
21.Time Between Symptom Onset & Hospitalization: Gauges the
amount of time between when a patient begins experiencing
symptoms and when they were hospitalized.
22.Number Of Visitors (Patients) Who Leave Without Being Seen:
Indicates the number of people who were unwilling to wait to see a
physician. This may help determine if more beds or staff are needed to
handle the number of patients coming in.
Care
23.Medication Errors: Measures the number of times there is an error in
prescribing medication at the facility. This includes when a mistake is

made in the medication, patient, or dosage, and it applies to both

inpatient and outpatient services.
24.Patient Vs. Staff Ratio: Demonstrates the number of staff available
per patient. May indicate whether the facility is overstaffed or
understaffed.
25.Patient Follow-Up: Measures the number of patients who receive
follow-up after their visit to the facility. This could be from a physician,
nurse, or other staff member asking about the visit and the patients
improvements.

http://www.beckershospitalreview.com/hospital-managementadministration/the-hospital-ceo-s-ultimate-dashboard-what-tocheck-daily-quarterly-and-yearly.html

Metrics and issues to monitor daily

One quick note before I dive in: In a LEAN environment the CEO might make
these actions part of his or her Leader Standard Work list.
1. Outpatient no-shows. Patient no-shows hurt productivity and cost the
healthcare industry billions each year. If you notice your hospital's numbers
are running high, it might be time to tweak your reminder system or switch to
a better one.
2. First case start-times. Prompt start times are crucial for preventing
delays and bottlenecks, and for keeping the OR running smoothly.
3. Patient volume. How many admissions are in the hospital each day?
4. "Door-to-doc" time in the emergency department. How long do
patients wait to be seen by a physician or advanced practice provider in the
ED? This has implications for staffing levels, patient safety, and patient and
employee satisfaction. This metric, those regarding the following two items
and those regarding wait times for certain other care processes are available
to the public on Medicare Hospital Compare. Patients will compare your wait
times with those of your competitors to decide which hospital to visit.

5. "Decision to admit to departure" time in the ED. How long does it

take from the time the emergency physician decides to admit a patient to an
inpatient bed to the time the patient actually leaves the ED for that bed?
6. Number of patients who leave without being seen in the
ED. Studies have shown LWBS visits are an indication of ED crowding and are
associated with longer ED wait times. Patients who leave the ED without
being seen are more likely to report worsened health problems.
7. Agency and overtime costs. It's important to look at agency costs
constantly, because when you use agencies you pay a premium price for
hospital labor. This may be a temporary cost if labor is assigned for a certain
project, but most of the time, high agency costs mean the hospital has a
turnover issue, a recruitment issue or most often, in my opinion a
retention issue. All three of these are strongly correlated with employee
engagement issues. Those who have high agency costs, might also have
lower patient experience costs because there are employees who don't know
each other and aren't familiar with the health system.
8. Major service issues. Are any patients upset? If so, it may be a good
idea to handle these situations personally.
9. Major engagement issues. Are any physicians or employees upset? This
is the time to address major issues in employee or physician morale.
Employee engagement affects patient safety and process improvement. That
one number can impact all sorts of things. I would suggest employee and
physician satisfaction be regular agenda items at your department head and
medical executive committee meetings.
Metrics and issues to monitor quarterly
While most of these issues need to be looked at continually, I recommend an
intensive review of them at least four times a year.
1. Quality metrics. How are the hospital's HCAHPS results? Process of care
measures? Outcome measures? Pay-for-performance changes make these
benchmarks particularly "hot," as they are directly linked to the health of
hospitals' operating margins.
2. Employee metrics. Are employees satisfied? How are turnover rates?
Employee engagement is essential to high-performance organizations. I
suggest holding employee forums quarterly to give employees a chance to be
heard.
3. Physician metrics. This includes referral patterns as well as satisfaction
ratings. It's important to ensure physicians are deeply engaged in hospital

operations and that they see your organization as a great place to practice
medicine.
4. Philanthropy. While most organizations zero in on philanthropy once a
year, quarterly is better in a time when so many hospitals are struggling to
sustain themselves. With government funding getting harder and harder to
obtain, philanthropy grows more important. Keep an eye on donations. Know
when donations increase and decrease, and understand why. Also, keep the
lines of communication open. It's important to provide the people who donate
money with regular feedback on where their funds went.
5. Board communication. I put this one in the "quarterly" bucket, but it
should probably happen more frequently than that. Communicate with key
board members vigorously and often. The end of the year is too late. Most
hospital CEOs are never formally measured on board communication. They
assume that going to board meetings is enough, but it isn't: if there's a
problem, it festers and will one day explode. The CEO should meet with every
board member individually to ask what he or she defines as healthy
communication. This is about clarifying expectations and measuring them so
the CEO is not surprised when an issue comes to head.
Steps to take annually
1. Hold an intensive leadership assessment. How aligned are your
leaders in terms of mindset and resources? Is there a universal sense of
urgency regarding the need for constant improvement? Are you taking the
right actions quickly and precisely? What about your systems and processes
do they hold people accountable for executing well? Studer Group offers
the Straight A Leadership Assessment to evaluate leaders, but if you don't
use this tool, find another way to measure these vital leadership issues.
2. Audit your evaluation system. How well do leader assessments match
up to the results they're responsible for? If most of your leaders receive a
"substantially exceeds expectations" rating, your organization needs to be
hitting most, if not all, of its goals. I find this is often not the case. If you're
using a subjective evaluation tool, rather than an objective one linked to hard
goals, it may be time to re-think your approach.
3. Evaluate vendor contracts. Look closely at these relationships in two
areas: cost and performance. A while back, I was talking to a hospital CEO
who was preparing for a reduction in force at his organization. I pulled up the
hospital's HCAHPS results and saw the organization was in the 12th percentile
for cleanliness. Its environmental services were outsourced. I would have
reevaluated that contract in a minute. Monitor the vendor costs not only
the market price but the cost in terms of performance. Remember, hospitals

can tie performance into their contracts with vendors. It's common in certain
areas, but could be common in more.
Conclusion
As I was writing this article, I struggled with whether to put "daily" items or
"annual" items in first position. I decided on daily, and for a reason. If you are
truly monitoring these crucial issues every day and making smart decisions
based on the evidence you're seeing your quarterly and annual tasks will
be much, much easier. Throughout the year, you will build a solid foundation
for your annual tasks, and you'll be deeply familiar with the issues.
Together, these checklists make up a "dashboard" that will help hospital CEOs
steer their organizations confidently through the hurricane of change that's
buffeting our industry.
I urge you to pay close attention to your dashboard. Sometimes, hospital
CEOs don't want to measure these issues when they anticipate a poor score
or outcome. For example, if they sense poor physician morale, they may want
to avoid measuring it and validating their fear. Or CEOs don't pin down the
metrics in order to avoid conflict with the board. They anticipate that board
members will not be pleased with the results, and they want job security.
CEOs need to look at these metrics as if they were physicians. Physicians do
not simply tell patients they don't want to measure their blood pressure. It
has to be done. Keeping tabs on the health of your organization has to be
done, too. It may mean enduring some discomfort up front and learning a
new habit but when you experience the long-term gains in your
organization's health, you'll be glad you did it.