1. Tools for Data Driven Decisions

2. FOR OFFICIAL USE ONLY 2 Agenda The Toolkit Designing for Outputs Understanding Tool Inputs Data sources Data collection Tool parameters Spreadsheet Tools Analytical Models Simulation Models

3. FOR OFFICIAL USE ONLY 3 Context, Purpose, Outcome 1) Context: Navy Medicine faces key operational decisions that can be made easier with the appropriate use of data through tools 2) Purpose: Guidance will be provided in choosing the right tool for the problem at hand, and examples of successful tools used for performance improvement will be discussed 3) Outcome: Identification of opportunities for decision tools and the appropriate application of these tools will lead to more confidence in future decision making

4. Tool Choice "When the only tool you have is a hammer, every problem begins to resemble a nail." – Abraham Maslow FOR OFFICIAL USE ONLY 4

5. 5 The Toolkit Spreadsheet Models Analytical Models Simulation Other Support Tools

6. FOR OFFICIAL USE ONLY 6 Designing for the Outputs What does the customer want out of the tool? What questions are to be answered? What is a usable tool for the customer? IT skill level Angle of interest What decisions will be made with this tool? Day-to-day operations? System-wide planning? Facilities/Construction? Beware of tendency to overdesign!

7. FOR OFFICIAL USE ONLY 7 Understanding Tool Inputs Data inputs must match tool choice Will the tool be “live” or based on a snapshot of available data Availability of input data impacts fidelity of output Quantity of data Granularity of data Quality of data Examples of data sources: Less specific: M2 More specific: Local data pulls (CHCS, Operating Room systems, Essentris) Custom to needs: Manual data collection

8. FOR OFFICIAL USE ONLY 8 Electronic Data Mining Reasons for electronic data mining Existing processes can be described by the data they generate Allows for massive sample sizes Examples of electronic data sources Coarse information: M2 Detailed information: CHCS, Essentris, S3, etc. Custom information: data from specially built applications such as a discharge board or triage board

9. FOR OFFICIAL USE ONLY 9 Manual Data Collection Reasons for manual data collection Validation of system data Needed data not available in system Examples of manual data needs Process times Hourly volume counts Processes for manual data collection

10. FOR OFFICIAL USE ONLY 10 Tool Parameters Queue types What are processes for serving customers? Levers Resources such as staff or rooms Volumes Process changes including sequencing and scheduling Process types Can be statistically described Acceptable service levels What is acceptable wait time? What is acceptable turn away rate?

11. Tool Parameter Examples Scheduling modalities Templates Random Shortest case first Queuing Number of queues Number of servers Process types Sequencing and location of process steps Capacity Rooms Staff Service Levels Wait time ALOS Resource utilization Patients deferred FOR OFFICIAL USE ONLY 11

12. FOR OFFICIAL USE ONLY 12 Spreadsheet Tools Software tools widely available Users familiar with interface Distributable Ability for modification Less robust when representing dynamic systems

13. FOR OFFICIAL USE ONLY 13 Birth Volume Tool What is the primary question? “How many births should be expected in catchment area X?” Who are expected tool users? High level decision makers, not “in the weeds” What decisions will be made with this tool? System-wide planning What-if ? analysis

14. FOR OFFICIAL USE ONLY 14 Birth Volume Tool Solution implemented: Spreadsheet Model Select whether you want to use the baseline for % direct care, population change and fertility rate. If not, select “No” and enter data in blue cells Forecast Results Learn more at Population Based Healthcare Delivery Design (II) Session: Wednesday 1100-1200

15. FOR OFFICIAL USE ONLY 15 OR Volume Tool What is the primary question? “How do changes in volume and capacity impact OR utilization” Who are expected tool users? Experienced analysts with report outs to decision makers What decisions will be made with this tool? System-wide planning What-if ? analysis

16. FOR OFFICIAL USE ONLY 16 OR Volume Tool Solution implemented: Spreadsheet Model

17. FOR OFFICIAL USE ONLY 17 OB Bed Sizing What is the primary question? “What is the facility capacity?” Who are expected tool users? Experienced analysts with report outs to decision makers What decisions will be made with this tool? Setting facility volume targets Construction needs

18. FOR OFFICIAL USE ONLY 18 OB Bed Sizing Solution implemented: Spreadsheet model Spreadsheet model has many assumptions Assumptions reduce data needs while providing reasonable answer Model can highlight the need for additional analysis if results are borderline

19. FOR OFFICIAL USE ONLY 19 OB Procedure Scheduling Model What is the primary question? “How should inductions and c-sections be scheduled to level demand” Who are expected tool users? Experienced analysts with report outs to decision makers What decisions will be made with this tool? A recommended schedule template for c-sections and inductions

20. FOR OFFICIAL USE ONLY 20 OB Procedure Scheduling Model Solutions implemented Analytical model produces a new template for scheduled procedures that levels day of week peaks

21. FOR OFFICIAL USE ONLY 21 Simulation Tools Software tools not widely available Limited familiarity with tools Very robust representation of dynamic systems Can require extensive data as inputs Can provide very granular results

22. FOR OFFICIAL USE ONLY 22 OB Simulation Model What is the primary question? “What is the capacity of our facility?” Who are expected tool users? Experienced analysts with report outs to decision makers What decisions will be made with this tool? Setting facility targets Construction needs

23. FOR OFFICIAL USE ONLY 23 OB Simulation Model Solution implemented: Simulation identified the bottleneck was MBU beds Additional analysis: “Assuming process and facility reconfigurations that alleviate the bottleneck, what is the new capacity” Solution recommended: Reclaim non-used LDRP rooms and keep vaginally delivered patients in the same room for entire stay

24. FOR OFFICIAL USE ONLY 24 Pharmacy Simulation Model What is the primary question? “What processes/equipment are required to meet performance criteria at a given volume” Who are expected tool users? Experienced analysts with report outs to decision makers What decisions will be made with this tool? Staffing decisions Facility decisions Equipment decisions

25. FOR OFFICIAL USE ONLY 25 Pharmacy Simulation Model Solution implemented: Simulation model Complex input needs Complex output processing needs

26. FOR OFFICIAL USE ONLY 26 Simulation User Interface Run all possible scenarios and present results in spreadsheet model Method for reducing demands on users Limit input requirements for front line

27. FOR OFFICIAL USE ONLY 27 Dynamic Decision Support Tools OB Forecasting Tool Answers the question “Should I accept or defer this patient” Used by front line staff Dynamically updated with live data