Data mining can yield treasures for RM
Data are everywhere these days, and you can put it to work for you. Health care providers accumulate huge volumes of data, and some risk managers are learning that the strategic use of that information can improve patient safety, reduce costs, and reduce liability risks.
Administrators at Bancroft Neuro Health, with facilities in New Jersey and Delaware, recently learned the value of data mining. Bancroft serves more than 1,000 individuals and families annually, with a wide range of services to children and adults with autism, developmental disabilities, brain injuries, and other neurological impairments. Toni Pergolin, CEO of Bancroft, tells Healthcare Risk Management that a thorough data analysis over the past two years is helping the company mitigate risk in its mental health facilities.
The focus on data yielded significant results for Bancroft:
Workers' compensation claims were cut in half. Since implementing the on-site medical team and a more disciplined focus on accident prevention and claims management, Bancroft's number of workers' compensation claims has been cut in half for the year spanning July 1, 2008, to July 1, 2009, compared to the previous year.
The number of days lost due to injury was reduced by 80% over the same period.
The cost of automobile liability claims cost was reduced by 78%.
The number of automobile liability claims was reduced by 40%.
Psychiatric and mental health settings provide unique challenges for engaging in risk management activities, especially when trying to understand where the potential issues are and where risk management needs to focus, Pergolin says. She had started at Bancroft as the chief financial officer, so she was strongly oriented to numbers and a data-driven approach. As CEO, she found that there was a real opportunity to use the company's data more productively in risk management.
"We had so much data, so we wanted to try to find the meaningful data and track it," she says. "As it got better or worse, we would know whether our actions were working."
Bancroft worked with The Graham Company, a Philadelphia-based insurance brokerage and risk management consultant specializing in high-risk businesses such as mental health organizations.
Scott Kegler, insurance producer at The Graham Company, helped Bancroft use data mining to reduce risk, and he says data analysis was the first step in the process.
"The deep analysis of the data is the most critical thing to do when trying to reduce any type of risk, but for many risk managers it is the step that can be overlooked," Kegler says.
Like most health care providers, Bancroft already had plenty of data. The challenge, Pergolin says, was analyzing that data and presenting it in a way that illustrated where the organization's particular needs lie. Kegler says one of the first goals was to use the data to prioritize risk management goals.
"You can't solve everything at once, so we needed to know what our top priorities would be," he says. "It was a matter of digging through the data to find the metrics that were really meaningful in risk management."
For instance, the team's analysis of workers' comp claims started with the most obvious statistic on the number of claims, but then they dug deeper to determine what type of accidents and injuries were involved, and then deeper still.
"We wanted to see if the wrist sprains, for instance, could be categorized into what was happening when the sprain happened. We looked for trends that showed that when an employee was involved in a particular task or a specific scenario, that's when the wrist sprain is most likely to happen," Kegler says. "Then we had to ask why they were doing that task that way and if there might be alternative ways to do that."
The analysis also looked into factors such as how long the employee had been with Bancroft, how much training the employee had received, which work area was involved, and what type of claims were costing the most money.
Risks and solutions found
Pergolin says the data analysis revealed three primary risks:
1. Clinical safety
Bancroft's mission is to help individuals live more independent lives. Because of this, its staff are always balancing the desire to give independence with the need for safety. While they want to give each person as much independence as possible, it needs to be done in a way that keeps the individuals safe at all times. This is a delicate balancing act that requires focus, discipline, and attention every day.
2. Employee injuries
Injuries to employees are not only expensive; they also have a negative impact on morale and Bancroft's ability to provide service.
3. Automobile accidents
Bancroft has a large vehicle fleet. It is imperative that the organization operates those vehicles safely every day.
The data analysis also led the Bancroft team to strategies to address these risks:
Two safety committees
One committee focuses on staff and environmental safety, including vehicle safety, and a second committee focuses on clinical safety. This has helped Bancroft target and prevent the specific circumstances that can lead to incidents.
Originally, Bancroft set up three safety committees, splitting the clinical safety into two groups with one focused on employee safety and one focused on patients. "But we found that there was so much interplay between the employees and the people they're serving that it made sense to bring those two groups together," Graham explains.
On-site medical care
A nurse practitioner is on-site five days per week to help reduce the frequency and severity of employee injuries. In addition, a physician comes on-site to meet with individuals who require follow-up care. Prior to the data mining, injured employees were sent to a general practitioner's office down the street and, in most cases, would send the employee to a specialist. Now, the employee is examined and treated immediately by the nurse practitioner with a focus on occupational health. The focused care has sharply reduced the use of specialists and reduced down time.
"This has helped us reduce our costs by treating injuries immediately so they don't have more expensive complications down the line," Pergolin says. "It also helps with employee morale and service delivery. Healthy employees give better service."
Root-cause analyses
Significant incidents, whether they result in injury or not, undergo a root-cause analysis.
Risk management report
Every month, Bancroft reviews detailed information from every major part of the operation. This information is summarized and put into graphical reports so that administrators can quickly see whether indicators are getting better or worse in any given area.
"It's a huge spreadsheet of data," Pergolin says. "We have 23 different programs at Bancroft, so the spreadsheet has 23 worksheets. That allows us to track all the different risk management indicators for each program, and then there also is the summary sheet that brings it all together."
Graham notes that the risk management report is largely proactive. Rather than tracking claims after the fact, the monthly report tracks unusual incidents or trends that could lead to liability if not corrected.
Quarterly employee injury reviews
Injuries still occur no matter what preventive efforts are in place, so every quarter the Bancroft administrators meet to discuss the status of open workers' compensation claims. Bancroft is self-insured for workers' compensation, so a third-party administrator comes in every quarter to review the open claims, along with Pergolin, the nurse practitioner, an attorney, consultants from The Graham Company, and other involved Bancroft administrators.
"Our objective is to have a plan to resolve every open claim in the most effective way possible," Pergolin says.
Sources
For more information on data mining in risk management, contact:
William Graham, CEO, The Graham Company, Philadelphia. Telephone: (215) 567-6300.
Toni Pergolin, CEO, Bancroft NeuroHealth, Haddonfield, NJ. Telephone: (856) 348-1193.
Data are everywhere these days, and you can put it to work for you. Health care providers accumulate huge volumes of data, and some risk managers are learning that the strategic use of that information can improve patient safety, reduce costs, and reduce liability risks.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content