Key Performance Indicators in ER What & How?
Transcript of Key Performance Indicators in ER What & How?
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Key Performance Indicators in ER What & How?
DR SARAVANA KUMAR Group Head - Emergency & Trauma
Head Clinical Operations
Quality Accreditation coordinator
Dr Mehta Hospitals,Chennai
National Joint Secretary - SEMI
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Our Objective in ED?
• To solve the patients’ health problems (efficacy) in the best manner (quality) and in the most economic way possible (efficiency).
•Performance = Extent to which set objectives are accomplished
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What is KPIs?
•Key Performance Indicators (KPIs) help to systematically monitor, evaluate, and continuously improve service performance
• "Signposts" in the Journey
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Well designed KPI's?
• Establish baseline information
• Set performance standards and targets to motivate continuous improvement
•Measure and report improvements over time
•Compare performance across geographic locations
•Benchmark performance against regional and international peers or norms
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OUTCOME PARAMETERS
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TRIAGE Interval
Time from patient arrival to time when triage is completed
for a particular category of patient
Left Before being seen
Total no. of Pat. who leave ED before examination / Tot. no of patients presented to
the ED during time of study X 100
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Initial Assess
Sum of time taken for the assessment / Total number of
patients in emergency
Pain Assess
Pat. with documented pain assessment using a validated
pain score / Total No. of pt presenting with pain X 100
Blood TAT
Total turn around time / Total number of blood & blood
components is used
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Imaging TAT
Avg. time taken for result of an imaging modality to be
available after the test is ordered.
Lab TAT
Avg. time taken for result of a lab test to be available after the
test is ordered.
Pres. Error
Total no. of prescription errors/ No. of total prescriptions X 1000
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Disp. Error
Tot. no of medication dispensing errors / No of total
prescriptions X 1000.
Discharge Time
Sum of time taken for discharge / No of Patients Discharged.
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LOS in ED
Tot. length of stay (in hrs) of all pts. in ED / No of pt visiting ED during that particular period.
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Pt Satisfaction
Avg. Score achieved / Max Possible score X 100
Nurse Pt. Ratio
No. of Nursing Staff / No of beds (each Shift)
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LAMA
Total no. of Pat. who LAMA / Tot. No of Pat. who presented to the ED during time of study
X 100.
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Equip. Down time Sum of down time for all critical
equipment in hrs in a month.
Return to ER No. of returns to ER with in 72 hrs with
similar presenting complaints / No of pat. Who have been discharged from ED.
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Fall No. of patients who fall from beds/
trolleys while in ED / Tot. No of Patients attending the ED X 100.
PEP Tot. no. of employees who were provided pre exposure prophylaxis / No of employees who
were due to be provided Pre exposure prophylaxis X 100.
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Proportion of Pat. with Acute Chest Pain - ECG
No. of pat. With chest pain who got their ECGs
within 10 min of arrival / Tot. No of Patients with chest pain where an ECG was done X 100.
Proportion of patients with ST - Thrombolytics
No of Pat. with STEMI who got thrombolytics within 30 min of arrival / Tot. no of Pat. who
received thrombolytics for STEMI X 100.
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Pain Mgt – Non analgesic 2. % of pat with pain not administered analgesic. a. No of pat. with pain who were not
administered an analgesic in ED / Total No of Patients with pain X 100.
Pain Mgt- Analgesic 1. Time taken to administer an analgesic agent after
arrival
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Proportion of Patients With STEMI - PCI
No. of pat. with STEMI where door to device
time of 90 min was achieved / Total no of STEMI patients who underwent PCI X100.
CT Scan following Head Injury
Avg. time taken for getting a CT head in pts
with head injury with GCS <15.
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App. of 3hr Sepsis bundle - Severe sepsis &Septic Shock
No of Pat. with severe sepsis or septic shock where blood culture was taken within 3hrs of arrival to ED & before administering antibiotics / Tot. no of patients with severe sepsis or septic shock where blood cultures
were taken in the ED X 100.
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Proportion of patients with eye emergencies
No of Patients in whom visual acuity was checked before performing any procedure / Tot. no of patients attending the eye emergency X 100.
Urine Pregnancy Test No of UPT performed in women in reproductive age
group (pain abdomen or bleeding per vagina ) / Tot No of women in reproductive age group who present with pain abdomen or bleeding
per vagina X 100.
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Spine Immobilization in trauma patients
No of pat. with suspected blunt trauma in whom cervical immobilization was done / Total no of
Patients with blunt trauma above clavicle X 100.
Time taken for Conducting LSCS after decision in ED
Mean of time taken for Cesarean section to perform
it is taken in ED.
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Complication Occurring in Emergency Delivery
a. No of Pt developing postpartum hemorrhage more than 500ml after emergency vaginal delivery / Tot. no of emergency vaginal deliveries done X 100.
b. No of Patients developing 3rd degree tear following emergency vaginal delivery / Tot. no of emergency vaginal deliveries conducted X 100.
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Neurovascular Status Documentation in extremity injuries
No. of patients with extremity injury in whom neurovascular status is documented / Total no. of patients with extremity injuries X 100.
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Proportion of Patients with Acute stroke- Investigation
Number of patients with suspected acute stroke where ECG, random blood sugar and CT scan was done within 25 minutes of arrival / Total number of patients with suspected stroke X 100.
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Focused assessment with Ultrasound in trauma (FAST)
Time taken from arrival to ED to performing FAST in patients with acute trauma
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Trans. Reactions
No. of transfusion reactions / No of Units transfused X 100.
CLABSI
No of Central line associated blood stream infection in a month / No of central line
inserted in ED in that month.
Mortality Rate No. of deaths / No of
discharges and deaths X 100
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Maternal Mortality Rate
Tot. no. of maternal deaths /
Total no of deaths X 100.
Infant Mortality Rate
Total no of Infant deaths / Tot.
no of deaths X 100.
Perinatal Mortality
No. of stillbirths and deaths in the first week of life / Total live
births.
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Thank you
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