Associations Between Lean IT Management and Financial Performance in US Hospitals.

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Quality Management in Health Care Pub Date : 2024-04-01 Epub Date: 2023-10-11 DOI:10.1097/QMH.0000000000000440
Justin Lee, Dorothy Y Hung, Elina Reponen, Thomas G Rundall, Aaron A Tierney, Pierre-Luc Fournier, Stephen M Shortell
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引用次数: 0

Abstract

Background and objectives: To understand the relationship between Lean implementation in information technology (IT) departments and hospital performance, particularly with respect to operational and financial outcomes.

Methods: Primary data were sourced from 1222 hospitals that responded to the National Survey of Lean (NSL)/Transformational Performance Improvement, which was fielded to 4500 general medical-surgical hospitals across the United States. Secondary sources included hospital performance data from the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS). We performed 2 sets of multivariable regressions using data gathered from US hospitals, linked to AHRQ and CMS performance outcomes. We examined 10 different outcomes measuring financial performance, quality of care, and patient experience, and their associations with Lean adoption within hospital IT departments. We then focused only on those hospitals that adopted Lean in IT to identify specific practices associated with performance.

Results: Controlling for other factors, adoption of Lean IT management was associated with lower length of stay ( b = -0.098, P = .018) and inpatient expense per discharge ( b = -0.112, P = .090). Specifically, use of visual management tools (eg, A3 storyboards, status sheets) was associated with lower adjusted inpatient expense per discharge ( b = -0.176, P = .034) and higher earnings before interest, taxes, depreciation, and amortization margin ( b = 0.124, P = .042). Such tools were also associated with hospital participation in bundled payment programs (odds ratio = 2.326; P = .046; 95% confidence interval, 0.979-5.527) and percentage of net revenue paid on a shared risk basis ( b = 0.188, P = .031).

Conclusions: Lean IT management was associated with positive financial performance, particularly with hospital participation in value-based payment. More detailed study is needed to understand other influential factors and types of work processes, activities, or mechanisms by which high-functioning IT can contribute to financial outcomes.

美国医院精益IT管理与财务绩效的关系。
背景和目标:了解信息技术部门实施精益与医院绩效之间的关系,特别是在运营和财务成果方面。方法:主要数据来自1222家医院,这些医院对全国精益/转型绩效改善调查做出了回应,该调查覆盖了美国4500家普通外科医院。次要来源包括来自医疗保健研究与质量局(AHRQ)和医疗保险与医疗补助服务中心(CMS)的医院绩效数据。我们使用从美国医院收集的数据进行了两组多变量回归,这些数据与AHRQ和CMS的绩效结果有关。我们研究了衡量财务绩效、护理质量和患者体验的10种不同结果,以及它们与医院IT部门采用精益的关系。然后,我们只关注那些在IT中采用精益的医院,以确定与绩效相关的具体做法。结果:在控制其他因素的情况下,采用精益IT管理与较低的住院时间(b=-0.098,P=.018)和每次出院的住院费用(b=-0.112,P=.090)有关,视觉管理工具(如A3故事板、状态表)的使用与每次出院调整后的住院费用较低(b=-0.176,P=.034)和息税折旧前收入较高有关,和摊销率(b=0.124,P=.042)。这些工具还与医院参与捆绑支付计划有关(比值比=2.326;P=.046;95%置信区间,0.979-5.527)和在分担风险的基础上支付的净收入百分比(b=0.188,P=.031)。结论:精益IT管理与积极的财务绩效有关,尤其是医院参与基于价值的支付。需要进行更详细的研究,以了解其他影响因素和工作流程、活动或机制的类型,通过这些因素和机制,高功能的IT可以促进财务结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Quality Management in Health Care
Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
1.90
自引率
8.30%
发文量
108
期刊介绍: Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.
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