Managing a hospital-based cancer center is a complex task and it is all too easy to become consumed putting out the daily fires, losing sight of the larger responsibility of maintaining an efficient and financially viable service line. A dashboard is an important tool in ensuring that the bigger picture is not neglected.
Like the dashboard in a car, the purpose of the dashboard is to provide important information on a regular basis in a manner that can be quickly digested and allows for appropriate actions. A dashboard should not be cluttered with information that is interesting but that does not provide valuable knowledge or opportunities for action. In other words, don’t measure something just because it can be measured.
In running a cancer program, there are 2 main types of information requiring periodic review: operational information and strategic information. Each category may have 1 or more key indicators that any given administrator wants to monitor, and the indicators may change over time. Further, the indicators may be volume oriented or they may be financially oriented. In either case, the most important reason to use a dashboard is to track performance over time and thus identify important changes in time to take any appropriate action. It is also useful to compare dashboard results with benchmarks, when those are available.
Choosing Your Information
To construct your dashboard, begin by answering 2 questions:
- What do I need to know to be sure that we are not losing ground?
- What do I need to know to be sure that we are progressing toward our goals?
For each answer, determine the measurable indicators. For example, if you define “losing ground” as decreasing volumes, then the volumes become your indicators: number of new registry cases, number of billed procedures, charges or revenue for a particular department, etc. These may be more specific if you are launching a disease-specific program or a new clinical service. If your goals are numeric, put those on the dashboard (eg, increased clinical trial enrollment, decreased negative biopsies). If those goals relate to progress of a nonnumeric project (eg, strategic plan initiatives such as developing multidisciplinary clinics), devise a milestone schedule and track your progress.
For most indicators, it is sufficient to review the dashboard monthly. That gives enough time to see the early results of any changes you have made. More frequent dashboard review is generally not advised, because it can place too much importance on small fluctuations. Some indicators, like tracking progress on strategic plan initiatives, may need only quarterly or even annual review (Tables 1 and 2).
To the maximum extent possible, a dashboard should be populated by data that are electronically available rather than requiring hand counts, and ideally the dashboard should update itself automatically through information technology systems.
The discussed indicators should serve as examples and should not limit your focus or creativity. A useful dashboard will show you, in a quick table or graph, exactly where you stand on the things that matter most to your success.
Teri Guidi is President & CEO of The Oncology Management Consulting Group, an oncology consulting firm that helps practices devise and implement