What gets measured gets managed

pressganeylogoThat maxim has been around for a long time and is an accepted tenet by most experienced managers. We need to be reminded that measuring the wrong things can result in managing the wrong outcomes. Measuring patient satisfaction in healthcare may be such an example.

Measuring patient satisfaction is the “new” metric of many larger healthcare organizations and hospitals. My wife’s employer allegedly ties staff bonuses to this metric as an example. However, what outcome is patient satisfaction actually measuring? Especially when the patient is not the payer.

Asking your level of satisfaction with the Ritz Carlton compared to a Motel 6 is likely to produce a preference for the Ritz Carlton in most people’s ratings. And if you don’t have to pay the hotel bill and yet have a choice where to stay anyway, most people would select the Ritz Carlton over a Motel 6. However, if one factors their own money into the equation, it may be that the two properties would score about the same because one’s expectations of Motel 6 are different, and if they meet those expectations at a fair price, they may score just as well as a Ritz Carlton does with its customers who expect more and pay more.

If you remove the payment from the equation and ask people how they feel about their medical outcomes, doctors are finding that for many patients over-treatment results in higher patient satisfaction scores. Not necessarily better medical outcomes. But if you are spending other people’s money (or at least you perceive it to be other people’s money) then who cares about over-treatment?

The three major organizations that now purport to be the arbiters of patient satisfaction, Press Ganey, Gallup, and National Research are establishing themselves as the standard. Given that a part of ObamaCare includes a reduction in Medicare reimbursement for lower patient satisfaction scores, puts hospitals in a dilemma. Of course the arbiters claim that “nobody wants to be evaluated” and that may be true. But if what gets measured does not actually improve the desired outcome and drives up costs, how is it helpful?

As always, before you start to measure, make sure you agree on the outcome you are trying to produce and that what you are measuring is reflective of that outcome. If patient satisfaction is the desired outcome, then the current metric is right. If better patient outcomes most efficiently are the desired outcome, the metric is likely wrong.

Mitch

 

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One Response to What gets measured gets managed

  1. Pingback: Meet Roland Harris, Chairman & CEO, Medida Metrics | MEDCRUNCH

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