Dr. Wilke GmbH. Inspiring Health

Peer-to-Peer Dialogue

Peer-to-Peer Dialogue in Action

Case study 1 – Optimizing documentation quality in a psychiatric clinic

It has been decided that in 2012 a new standardized remuneration system will be introduced the field of psychiatry. The idea is to define activity-based funding based on an individual patient’s actual consumption of resources. Each hospital has to provide transparent documentation that fully complies with regulations and will pass external audits.

What We Did

First of all, we assessed the documentation and coding quality of patient records in the psychiatric hospital by using a standardized tool that allows benchmarking between different medical departments / wards and comparison with other hospitals. We peer-reviewed more than 400 medical records. When doing so we also double-checked whether the documentation actually reflected the existing patient severity classification (PsychPV).

All results were presented to a work group consisting of hospital pychiatrists, nursing staff and controllers. Based on the findings we were able to pinpoint areas which needed improvement e.g. standardizing the documentation and designing special forms. An implementation plan was approved. The peer-review was repeated twice with our external support. The results were improving continuously. Now the clinic maintains the dialogue by itself on a quarterly basis and uses the structures (documentation scoring, standardized assessment etc.) we introduced.

Case study 2 – Optimizing OR capacities

An analysis of process times with our OR-benchmarking (ORB) tool revealed opportunities for improvement in the areas punctuality in the morning, changing time between operations, idle and overtime in the afternoon.

What We Did 

We supported a peer-to-peer dialogue among a group of experts (surgeons, anesthetists, nurses) from the OR for over one year. In the first meeting, we defined actions based on key data from our ORB. Apart from developing an action plan, we defined key performance indicators (KPI) and targets we wanted to reach by the end of the year. Each action was directly related to one of the KPIs and based on the idea of lean healthcare management, which aims at reducing mudas (=waste) . In monthly meetings each expert reported the progress of the change measures to his or her peers and we analyzed the development of the KPIs. At the same time, we set up a coaching process for two of the experts who will take over and continue the dialogue later.