A key way to propel our hospital data to the next level of usefulness is to consider where our “red lines” are. The manufacturer of our car has thoughtfully provided a bright “red line” on the tachometer that lets us clearly know when we are entering the “danger zone.” If we operate our car’s engine above this “red line” we are likely to do damage – either immediate or long-term.
Some of our hospital data is just as important as the RPMs in our car’s engine. If we exceed their “red line” it is likely to result in harm – again, either immediate or long-term.
The benefits of clear “red lines”
Clear “red lines” etch a line in the sand that allows our culture to say, “We are not going there” or “We don’t do Red!” Without a clear trigger for action, we disconnect our data from the real-life needs of actually managing the facility. While our leadership teams appreciate data, what they really want is to be able to use data to manage the facility more safely, effectively and efficiently. Let’s help by carefully choosing and applying some clear “red lines” for our most important processes.
Often hospitals reply, “We have lots of red lines on our dashboards.” But are these really meaningful? Just because the dashboard square turns “red” if we are more than x% from the benchmark, is that a real indication of “immediate or long-term danger” or just a fast shortcut? Even worse, do the vast spreads of “red” on a dashboard lull us into complacency and mask the real “red lines”?
Where we can use “red lines”
Some examples of meaningful “red lines” might include:
- When the daily census exceeds a certain limit, that is a clear “red line,” and we must respond by balancing our loads.
- When the volume of patients in the ED exceeds a certain number, we have “red lined” and may have to take extraordinary action like diverting patients to another facility.
- When the number of orders per pharmacist or lab technician exceeds a certain limit, we may move into the danger zone of increased delays and potential higher error rates.
- When the overtime rate exceeds a certain point, we may increase employee fatigue and the potential for serious errors.
- When staff turnover exceeds its “red line,” we may reach a dangerous period of reduced morale, potential understaffing, and inability to safely perform all the things we need to do.
Making it happen
Start by setting five to ten “red lines” cooperatively among the board, leadership team, quality committees and quality management. Determine how frequently the “red lines” have to be monitored, and how they will be communicated. Many of these are likely daily measures and are ideal to be followed in the daily huddles.
Adjust the “red lines” as necessary, but remember that it should alert the organization to an immediate or long-term danger. You may not hit many of your “red lines,” but it takes only one time to “blow out your engine!”