It is surprising how many HME business owners who have not yet pursued accreditation are unfamiliar with the term “Performance Management”. An even more startling factor is that most business owners who have already started the accreditation process are still confused about what a Performance Management plan and process should look like when it is in place in their HME business.

It must be explained that Performance Management used to be called Quality Improvement, or QI.  That terminology has been discarded in favor of the new name, Performance Management.  These concepts are, however, one and the same. 

The Performance Management Plan explained

Let’s talk first about what Performance Management plans involve, and then let’s cover how to implement them in your business for an effective outcome.

In layman’s terms, a Performance Management Plan is a method for implementing ongoing, systematic, objective, organization-wide business assessment tools, along with a process for improving the outcomes that are measured.

The primary objectives of a Performance Management plan are:

• To monitor and enhance your company’s policies, procedures, and practices to ensure high quality services.
• To identify, track and resolve problem areas.
• To meet regulatory and accreditation standards.
• To monitor incidents, accidents, and infections so that reoccurrences are minimized.
• To monitor satisfaction rates to ensure that the needs and expectations of the customer are met.

With these objectives in mind, we must find ways to measure the factors involved. This is accomplished by creating ways to collect data from information that you already monitor within your organization.

Some examples of information sources are as follows:

1. Customer satisfaction surveys
2. Complaint logs
3. Delivery records
4. After-hours telephone logs
5. Patient files
6. Incident report logs
7. Supervisory reviews

To collect data from these sources of information, a data collection tool should be created. The data collection tool can be a simple chart with the items to be reviewed listed on one side, along with an area to record the outcome of sampled data beside it.

Once collected, the data should be analyzed to tell you how well your business performed in a certain area. You can then set goals to improve in those areas needing improvement.

How a Performance Management Plan is implemented through data collection

Now that you’ve had this brief tutorial, let’s look at an example.

An excellent area to monitor your businesses performance is in the area of patient files. Let’s say that your goal is to have a signed physician prescription in every patient file within 20 days of the date of service.

The first step would be to determine how many files you want to review to see if this standard is being met.  Generally speaking, you should review at least 10% of the patient files over a selected period of time, let’s say 6 months.  

Next, you prepare a data tool that enables you to check “yes” or “no” to your question: Is there a signed physician prescription in the patient chart? After this you would begin compiling data. Once the data is compiled, add up how many “yes” answers were obtained. Dividing the number of “yes” answers by the total number of charts reviewed gives you the percentage of correct responses achieved.

Then you would determine the percentage of complete charts you would like to achieve for this goal. If you had 50% of your charts in compliance and you desire to have 100%, determine a time frame in which to achieve the goal and how you desire to achieve it.

You might decide to …

• set up a reminder system for any incomplete charts to be reviewed regularly
• keep incomplete charts in a separate area
• call the MD in 10 days to remind them to send the prescription
• ask a sales rep to hand-carry prescriptions and CMNs for signature
• set up a fax system with doctor’s offices to receive prescriptions more efficiently

After you have identified the areas for improvement, determine a time frame for implementation and when the next review period will be. At the end of the review period, perform the analysis of the patient files again. Use the same number of files to calculate the percentage of correct files. The result will tell you whether or not the new procedures were effective.

You now have valid results to report as a part of your Performance Management Plan.

Let’s consider one more example of key data collection

You know that the FDA requires you to track the lot numbers on all of the oxygen cylinders you dispense.  Let’s assume, however, that your drivers, therapists and warehouse staff have trouble remembering to document the lot numbers.

Here are the steps you could take:

1. Perform an audit or collect a sample of a percentage of deliveries to patients.
2. Ask your question: Was the lot number on the oxygen cylinder recorded in the proper place when delivered?
3. Record the number of “yes” responses and compare them to the total charts reviewed. Divide the “yes” responses by the total reviewed to determine your percentage of correct answers.
4. Next, develop a plan of action to improve your process and to determine the percentage of correct responses you desire to set as a goal for your staff.
5. Measure the improvement after a selected period of time, and record the rate of improvement.

This very same procedure can be used in all areas of your business. It will give you the information you need to help you continually improve your business and its processes for greater customer satisfaction.

Organizational changes are necessary

The Performance Management Plan that you implement for HME Accreditation will require you to designate a Performance Management Coordinator. This individual is responsible for directing the activities of your Performance Management Plan, and for reporting the results of these efforts. 

Equally important is forming a Performance Management Committee to review the documentation you compile, and to help determine which areas should be reviewed. This type of committee usually meets quarterly to review the results from the previous quarter.

Your Performance Management Plan is your foundation for change

Once implemented, your Performance Management Plan can be one of your best-kept secrets for success and for providing the consistent level of excellent service you desire.

A sound Performance Management Plan is one of the hallmarks of a business that operates with excellence. This vital area is appropriately emphasized in the HME accreditation process.