When looking toward the road ahead, drivers rely on their vehicles' dashboards for guidance. The myriad of dials, gauges, and digital displays help them travel safely and swiftly.
The speed and nimbleness with which behavioral healthcare managers must navigate today's market makes a corporate dashboard equally useful for driving performance improvement.
Dashboards: Tools for accountability
The term dashboard, sometimes used interchangeably with key performance indicators or scorecard, has gained wide acceptance as a systematized approach to accountability and, by extension, performance improvement. “You can say that your organization is ‘good.’ Can you prove it?” asks Ron Brown, executive director for Three Springs of North Carolina in Pittsboro, NC. “Dashboards enable our organization to measure a client's improvement over time and monitor client and employee satisfaction. Our staff and other stakeholders, including referral sources, want to see the progress our clients are making.”
Collecting and analyzing data allows managers to quickly recognize trends, leverage stellar performance, and shift support to programs that are not achieving their objectives. “Today's environment demands accountability. Performance indicators-or dashboards-transform data into actionable information,” says June DiPolito, executive director of Pineland Community Services of Statesboro, GA.
The uses for the information are as numerous as the various measures employed. In addition to addressing pressing matters identified in an organization's financial health or client outcomes, the data can help spur conversations regarding how to “support a struggling department, reward employees who are excelling, identify future leaders within the organization who might benefit from focused mentoring programs, or capitalize on organizational strengths to be used for future RFP (request for proposal) responses,” says Bontiea Goss, executive director of programs and services for Alternative Opportunities of Springfield, MO. “Establishing carefully constructed dashboard measures can add integrity to your management process by helping management understand benchmarked performance. The level of subjectivity or arbitrary nature of decisions is lessened.”
Figure 1. Dashboard home page. From this page, users may select a category and access graphs or drilldowns of more detailed data.
Many organizations begin with financial indicators for their dashboards, including margin, day's cash on hand, receivable base, and debt/leverage ratios, and then expand to review other fiscal indicators such as billing, census, admissions, discharges, and staff productivity. Traditionally, this type of information has been part of the reports submitted to boards of directors and thus provides a good platform for exploring other topics such as quality measures, clinical factors, human relations, and risk management.
Risk management dashboards report risk incidents that might include “the number and type of worker compensation incidents and critical program incidents, such as medication errors or consumer deaths,” says Tony Zipple, CEO of Chicago-based Thresholds.
Quality dashboards continually grow in their relevance. “We use evidence-based fidelity scores, which include items such as illness management recovery, supported employment, integrated disorder treatment, and number of psychiatric hospitalizations,” Zipple adds.
Many human resources dashboards have significantly expanded beyond measuring turnover rate, now emphasizing factors like cultural diversity. “Over the past seven years, our CEO and board have made a commitment to building a more culturally diverse organization,” says Penny Free, executive vice president of TERROS of Phoenix, AZ. “We include a diversity dashboard that tracks the ethnicity of our staff and compares it to the ethnicity of persons served. The purpose is to use this information to continually improve the balance between the two.”
Indeed, cultural nuances can be uncovered in the data. “Outcome data are perhaps most interesting for the questions they raise. For instance, we suspected and confirmed that our effectiveness is different for different tribal referents,” says June O'Brien, director of the Northwest Indian Treatment Center of Elma, WA. “There are obvious access differences between large, rural reservations and more urban contexts, but there are also differences in the historic trauma of different tribal communities, as well as current pressures. These differences and pressures have implications for more targeted treatment and aftercare support. As a result, we wrote grants to strengthen and expand our approach to treatment, direct more comprehensive data collection, and tailor aftercare efforts in the home community of the referents and alumni.”
Figure 2. No Show graph. When a user selects the No Shows category from the dashboard home page, he/she can access detailed data, such as the graph above which tracks cancelations by client, staff, or no shows over the course of a year. Notice that the number of no shows has increased significantly from May to June. “Drilling down” further into this data allows the user to investigate underlying causes.
O'Brien continues, “For us, examining the outcome data raises questions about trends suggested, but not directly reflected, in the data. We use the same process in other areas, including revenue trends. We can clearly see what the data says, but there are other subliminal messages.”