1. Benchmarking for Organizational Excellence in Addiction Treatment 2009 SAAS National Conference/ NIATx Summit Paul M. Lefkovitz, Ph.D. July 30, 2009

2. 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?

3. 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!

4. 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

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

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

7. 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

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

9. 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

10. 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

11. The Importance of Formal Comparative Benchmarks

12. Comparative Benchmarking in Your Daily Life What examples of comparative benchmarking have you encountered in your own day-to-day activities?

13. Important Benchmarking Concepts Benchmarking differs from formalized research or laboratory science Benchmarking views data as a vehicle rather than a destination Benchmarking generates ideas and hypotheses---not answers Benchmarking is a communal activity

14. Benchmarking as an Impetus to Action Human nature gives benchmarked data its power Raw data tells no stories Benchmarked data draws comparisons Nobody wants to “bring up the rear” Benchmarked data prompts action

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

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

17. 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

18. Process Benchmarking Methodology Typically performed in workshop settings Guide to Participation distributed in advance to allow participants to respond to questions that will be posed about methods used Audience polling technology used to permit anonymous involvement and immediate analysis of data

20. Surprises Abound What is expected usually does not materialize Top performers do not know why they perform well Subtle factors often prove to be powerful

21. Process Benchmarking In Action The identification of “best practices”

22. Internal Benchmarking All concepts also apply to internal benchmarking Descriptive, comparative or process benchmarking can be conducted within an organization Examples of internal comparative benchmarks: –Productivity differences among staff –Access differences among locations –Unit cost differences among programs –Staff satisfaction differences among leaders

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

24. 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

25. 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

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

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

28. 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

29. 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

30. Organizational Climate Staff Retention/Turn-Over Staff Morale/Satisfaction (Measure and scoring to be provided) Percent of Staff Position Vacancies (Counselors)

31. 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

32. 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

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

34. 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” Previous Scores

35. Standard Benchmarking Report

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

37. Executive Summary Report

38. Executive Summary Report II

39. Run Chart Track your data over time Trend analysis Examine interplay among different benchmarking dimensions

40. Run Chart

41. 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

42. 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

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

44. One Year Subscription Fee Annual Subscription Fee: $1,000- includes all aspects of initiative Conference Special for those that sign- up on site-$900

45. Questions? Contact: Paul M. Lefkovitz, Ph.D. President, Behavioral Pathway Systems 877-330-9870 (Toll-Free) plefk@bpsys.org www.bpsys.org BPS is Booth #33 in the Exhibit Hall