Implementation Plan Paper
University of Arizona
Measuring Performance Standards
September 14, 2009
Implementation Plan Paper
Change is an inevitable part of business and organizations should prepare to meet the challenge of adapting the quality of their product to match the needs of their customers. This goal can be met by establishing a vision for this change and by defining the exact outcomes the organization hopes to achieve for the final product. Depending on the scope of the change, the implementation process can vary widely in time, required resources, and complexity but the basic steps involved to achieve the vision are the same. The steps include identifying and defining the problem, analyzing data, creating a plan, measuring the outcomes, and reevaluating the final product (Dlugacz, Greenwood, & Restifo, 2004). An actual process improvement and implementation plan for CIGNA Onsite Health or COH will provide an example to illustrate how this process works in the real world. Core Performance Measure
The vision for this implementation plan is to improve the management of diabetic patients who use the onsite health clinics. This core performance measure is an important part of the COH mission, which includes maintaining health and lowering the cost of health care. Diabetic patients who manage their health can avoid many of the more serious and costly problems associated with the disease. Figure one analyzes this core performance using a Hoshin Tree diagram.
Improving the management of diabetes requires that COH understand and evaluate the current process in order to produce the desired change. How does COH know if they are managing their diabetic population better than before or even if they are managing their health well at all? An important part of this process is to define the data that provides a reasonable assumption that the program is successful. These data points are often called performance indicators. In most cases, measuring performance requires several performance indicators to define the level of quality and this is true for measuring diabetic management. Biometric Results
One of the easiest measures to define quality for this plan is biometric results. Biometric testing is performed on diabetics to monitor and assess the status of the disease. Although some some debate exists over biometric values and there correlation to disease risk, they are generally recognized as a good indicator of health. Some examples of biometrics diabetic biometrics include glucose levels, HbA1C results, cholesterol and urine micro albumin testing. Numbers, like biometric values, are easy to measure, compare and trend over time. This makes biometrics an excellent performance indicator. Medication Compliance
Another performance indicator is medication compliance. Medications are prescribed because the provider believes that it will improve their patient’s health. For many diseases, the consequences of not taking recommended medications can be severe. This is true for diabetes and why it is important to ensure that they are compliant with their recommended medication regiment. Health Care Utilization
Diabetes is a chronic illness and is best maintained through regular preventive care from a health care professional familiar with their disease. While visits to a PCP or specialist are generally considered indicators of good health maintenance, visits to an ER or inpatient hospital are usually viewed as negative indicators of overall health. Using this methodology to determine a correlation between health maintenance and visit type would seem flawed due to the number of unknowns associated with the data. Utilizing the ER for a broken arm or a car accident probably have nothing to do with diabetes and therefore should not be viewed as a negative indicator of health....