Benchmarking for Organizational Excellence in Addiction Treatment Paul M. Lefkovitz, Ph.D. President, Behavioral Pathway Systems

The Measurement of Organizational Performance Performance is measured in all addiction treatment settings How helpful is performance data? Does data drive organizational vision? Does data drive organizational decision- making?

The Limitations of Outcomes A thermometer reading would be of no value as a measure of your health… If you didn't know that 98.6 is the “average” temperature!

The Limitations of Outcomes in Your Organization Similarly, knowing that your missed appointment rate is 27% is of little value in evaluating the health of your agency…if you don’t know how others are performing

Data without Meaning We are deluged with data without meaning Data without a context is just a bunch of numbers What is the answer?

The Role of Benchmarking Benchmarks provide the vital external context for understanding your outcomes

Benchmarking Defined Gift and Mosel (1994) define benchmarking as “the continual and collaborative discipline of measuring and comparing the results of key work processes” Gift, R. and Mosel, D. (1994). Benchmarking in Health Care, American Hospital Association

A Tiered Model of Benchmarking Descriptive Benchmarking Comparative Benchmarking Process Benchmarking Each builds on the preceding type

Descriptive Benchmarking Most common form of benchmarking Industry overviews, government reports Static snapshot of industry performance No formal or statistical comparisons between an organization’s performance and industry norms “Eyeball analysis” can be misleading

Comparative Benchmarking Formal comparison of an organization’s performance against a descriptive benchmark Typically reported as percentile rankings but can be reported in graph form also

The Importance of Formal Comparative Benchmarks

The Limitations of Benchmarking Benchmarks profile your organization against others and help identify opportunities for improvement

Improve? How? Benchmarks do not give any indication as to how to improve

The “How”: Process Benchmarking Based on a simple premise: The methods of top performers differ from those of others Process benchmarking systematically compares tactics of top performers with those of others Methods that distinguish between top performers and others may be regarded as potential best practices

Benchmarks: Where are They? Readily accessible, relevant and affordable comparative benchmarking data is hard to come by

Benchmarking for Organizational Excellence in Addiction Treatment SAAS, NIATx, and Behavioral Pathway Systems are partnering to sponsor an addiction-specific national benchmarking initiative BPS specializes in behavioral health and human services benchmarking and has numerous state and national benchmarking initiatives underway

Objectives of Benchmarking Initiative Provide SAAS with information it needs to advocate for its members Provide participating organizations with individualized comparative benchmark data that can serve as a vital context for understanding measured outcomes Provide a powerful vehicle for the identification of best practices and organizational improvement through process benchmarking and the application of NIATx principles

Benchmark Selection Process National interest survey conducted Interest Availability of Data 354 respondents Survey findings guided Steering Committee decisions

Scope of Benchmarks Comprehensive range of benchmarks Operational, clinical, organizational climate, and financial domains of performance 21 benchmark dimensions Approximately 150 input metrics

Operational Benchmarks Initial Access Length of Stay/Utilization, by Level of Care Subsequent Access (Number of days from intake to first treatment appt) Average Caseload Size of Clinician, by Level of Care Outpatient Productivity Average Group Size

Clinical Benchmarks Engagement/Retention, by Level of Care Outpatient No-Show/Cancellation Rates Client Satisfaction/Perceptions of Care Degree of Engagement with Recovery Support Services Involvement of Significant Others

Organizational Climate Staff Morale/Satisfaction (25 Item Measure and automated administration and scoring to be provided) Staff Retention/Turn-Over Percent of Staff Position Vacancies (Counselors)

Financial Benchmarks Cost per Unit of Service, by Level of Care Salaries, by Role Administrative Overhead as a Percent of Total Expenses Payer Mix Current Ratio (Assets Divided by Liabilities) Net Days in Accounts Receivable Days of Cash on Hand

Data Submission On-line benchmarking survey Aggregated anonymous data-no complicated encounter-level data No software needed User-friendly, encrypted and secure Available 24/7 Submit relevant and available data--no reporting requirements State-of-the-art on-line data validation

Benchmarking Reports Standard Report Executive Summary Report Organizational Climate Report Run Charts

Standard Benchmarking Report Normative Data –Sample Size –Mean –Median –Standard Deviation Comparative Data –Overall Percentile Rankings –Peer Group Comparisons (budget size, geographic area, setting) “Apples to Apples” –Maine Norms Previous Scores

Standard Benchmarking Report

Executive Summary Report Designed for busy senior leaders and boards Graphic representation of scores Brief, key highlights

Executive Summary Report

Executive Summary Report II

Run Charts Track your data over time Trend analysis Examine interplay among different benchmarking dimensions

Accommodations for Multiple Locations Satellite locations easily accommodated Each location can be benchmarked independently to produce a separate report No limit to number of additional locations

Moving Beyond “the Numbers” Benchmarking is not just about data When data is generated, real fun begins Identify potential best practices through process benchmarking and other vehicles Enhance organizational performance through NIATx principles Emphasis on shared learning from one another and from “top performers” A learning community

Shared Activities and Available Resources Monthly audio-conferences/user support meetings Monthly newsletter to educate and inform Telephonic and user support Free telephonic consultation in interpreting your data and developing improvement strategies Articles and other resources

One Year Subscription Fee Annual Subscription Fee: $1,000 Includes all benefits described Brochure/Order form available through SAAS

Questions? Contact: Paul M. Lefkovitz, Ph.D. President, Behavioral Pathway Systems (Toll-Free)