Are you measuring what you can control?

Infection rates, readmission rates, complications, stroke, and heart attack outcomes. 

These are the metrics you report to your board every quarter. Leapfrog and other nationally recognized evaluators make those numbers public, and the implication is clear: these metrics are supposed to show how good your hospital is.

They also put enormous stress on CEOs. Hospital executives track these numbers closely, and their board holds them responsible for every fractional change. 

What most don’t understand: 50-80% of these outcomes are out of a hospital’s control. 

Instead of only measuring factors that depend on your patient population, such as comorbidities and disease rates, you need a way to measure the quality of care that your hospital provides. 

Once you begin tracking the numbers you can control, the national reporting metrics around your hospital will also likely improve.  

Here’s what’s direct, measurable, and within your control:

Physician-culture fit and patient access.

Good culture fit leads to better patient access, which in turn leads to better Leapfrog outcomes. At Preferred Solutions, we’re helping executives track the impact of physician-fit, and the connection to overall staff retention and patient outcomes is clear. 

If you want to tell the complete story of your hospital’s performance, use all three of the following: physician-culture fit, patient access, and national reporting like Leapfrog. 

You can present it to your board and peers like this: “Leapfrog outcomes are what we see above the water line. They’re the visible metrics, but they’re not everything. Culture fit and patient access also impact these scores. Let me tell you more.” 

By using this comprehensive approach (all three layers) you can report on signals that inform all of the top-level metrics that come after. 

In most hospitals, it’s not a physician's lack of clinical skills that create problems, it’s fit. When there’s true culture fit, 80% of day-to-day friction disappears. Communication improves and process conflicts drop. Your staff turnover slows.

Not as subjective as you might think—culture fit is something you can track. 

Documenting culture fit can be as simple as a “Yes or No” from staff. Once a physician has joined, ask nurses if they’re happy. You’ll quickly see the correlation between staff happiness and a viable program.

How to track it: With “thumbs up or thumbs down” scoring after the first few weeks of a physician’s onboarding. Use a “+” or a “-” as a direct measurement. Document what your team says too: whether it’s "they fit right in" or "they don't respond to calls." These anecdotal proof points can help you read between the lines and provide context behind the numbers. 

When your physicians “fit right in,” they stay longer, communicate better, and build stronger relationships. 

A stable physician, nurse, and staffing roster means better capacity. Better capacity leads to better patient access. More patients get seen. Less experience long wait times, scheduling issues, or the need to get transferred. These are concrete results, but getting there requires the right human touch. 

How to track it: Track the number of days or weeks on average it takes patients at your hospital to get an appointment: “time of referral to appointment scheduled."

Track the number of days from “test completed to results delivered.” These are test results with an explanation from a member of your staff. These are not just the test results arriving in the system. Set a baseline, track it monthly, and measure changes.

We don’t need to complicate it, the approach can be this easy.

Leapfrog metrics have long been the easiest data to compare nationally across hospitals. It is the data that we do have, not necessarily the data that we want. There needs to be a system in place that hospitals can follow in order to improve. We’re just reshaping it. 

The surface-level metrics are just that. They imply “good” or “needs improvement” without much nuance. By presenting these numbers alongside layers 1 and 2, you get closer to the truth:

At Preferred Solutions, we help executives diagnose patient needs, find the right physicians, and build system-based healthcare programs that scale. We do this through our work with hospitals across the country. We track all three layers of hospital growth, and we've seen how much the visible metrics improve when the foundation is stronger.

How to track it: You already are. Evaluation groups like Leapfrog pull from insurance databases automatically. The shift is to present all three layers together instead of only the iceberg’s tip.

If you’re concerned about time-to-consultation and time-to-test-results, know this: success here depends on developing processes the whole team can follow. When only one physician knows how something works, it breaks the moment they leave. Their process was never a process for all to follow.

We work with healthcare systems to establish processes that help build sustainable programs. This is something we will take a closer look at in upcoming issues. 

Let’s continue the work.