Why systems should ditch ‘metric madness’

Systems have a habit of piling metric upon metric on physicians to help drive performance at their hospitals, but this “metric madness” can be detrimental to physicians, according to a March 4 article on the American Medical Association website.

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In many cases, physicians are held responsible for metrics they cannot or should not be expected to manage, John Sawyer, PhD, medical director of professional staff experience at New Orleans-based Ochsner Health, told the AMA.

“Metrics are important. It’s like with school — we need grades or we’re probably not going to study,” Dr. Sawyer said. “[Physicians are] going to want to do well on it, and if they don’t, it’s going to be distressing.”

Some physicians are rated on parking or food in the hospital despite having no control over those aspects. 

“Something that we need to think about is to what extent is the physician influencing that metric versus someone else, and should they even be accountable to it because they’re not able to influence it,” he said.

It is up to health systems to determine which metrics are important for physicians. For example, some metrics measure if a physician responded within 24 hours, the quality of care and patient experience can be better measured on a team scale rather than just on the physician.

“The intention around having shared goals is that people are aligned,” Dr. Sawyer said, and “sometimes with shared goals, if we have no control over it, then it can also create resentment.”

For that reason, “we need to look at both sides of metric responsibility,” he said. “So, what do we need to really be aligned on? And then what can we do to make sure we’re not feeling as if we’re blamed for stuff that we don’t have any control over?”

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