Preface

Healthcare expenditures will continue to grow in the next two decades. Showing the value for the expenditures in terms that resonate with all stakeholders is imperative. Changes in payment methods from a fee for service (utilization) to a more quality-centered, pay-for-performance product will reward providers that show improvement in quality and efficiency. Centers for Medicare and Medicaid Services (CMS) and others will likely award contracts and favorable revenue arrangements to providers that demonstrate value via the outcomes. All healthcare systems are working toward building internal systems that not only deliver better outcomes but also prove them.

Executives are now asking for the return on investment (ROI) on major healthcare projects in technology, quality, patient satisfaction, procurement, process improvement, case management, staffing, compliance, innovation, marketing, and other functional areas. Using the method outlined in this book, you will be able to deliver the ROI in a credible, reliable way.

The ability to connect the dots and show bottom-line accountability while maintaining quality and efficiencies will be the key to survival in the healthcare industry. When the measurement processes in healthcare are examined, it becomes apparent that no method is consistently used to show the value of various projects and programs. The ROI Methodology, developed and refined over two decades, has worked its way into the healthcare field with dramatic results. “Show me the ROI” is the familiar response from individuals asked to invest (or continue to invest) in major projects. At times, this response is appropriate. At other times, it may be misguided; measures not subject to monetary conversion are also important, if not critical, to most projects. However, excluding the ROI from a successful profile is unacceptable in this age of the “show me” generation. The ROI is often required before a project is approved. Sometimes, it is needed as the project is being designed and developed. Other times, it is needed after project implementation.

This issue is compounded by concern that most projects today fail to live up to expectations. A systematic process is needed that can identify barriers to and enablers of success and can drive organizational improvements. The challenge lies in doing it—developing the measures of value, including monetary value, when they are needed and presenting them in a way so that stakeholders can use them.

This book is a basic guide for anyone involved in implementing healthcare improvement projects—systemwide medical procedures, technology implementations, systems integration, new quality processes, physician engagement, nurse retention, risk management, leadership development, or any other type of project where significant expenditures of time and money are at stake. Strategies to assist in forecasting the value of the project in advance and in collecting data during and after project implementation are presented. This book uses a results-based approach to project evaluation, focusing on a variety of measures that are categorized into six data types:

1. Reaction

2. Learning

3. Application and Implementation

4. Impact

5. Return on Investment

6. Intangibles

This book offers a step-by-step guide to identifying, collecting, analyzing, and reporting all six types of data in a consistent manner that leads to credible results.

This unique book focuses on building a credible process—one that will generate a balanced set of data that are believable, realistic, and accurate, particularly from the viewpoint of sponsors and key stakeholders. More specifically, the methodology presented in this book approaches credibility head-on through the use of:

• A balanced set of data

• A logical, systematic process

• Guiding Principles, a conservative set of standards

• A proven methodology based on thousands of applications

• An emphasis on implementing the methodology within an organization to ensure that the process is sustained

• A procedure accepted by sponsors, clients, and others who fund projects

The book explores the challenges of measuring the hard-to-measure and placing monetary values on the hard to value. It clarifies much of the mystery surrounding the allocation of monetary values. Building on a tremendous amount of experience, application, practice, and research, the book draws on the work of many individuals and organizations, particularly those who have attained the ultimate levels of accountability using the ROI Methodology. Developed in an easy-to-read format and fortified with examples, CEO highlights, and quick summaries, this guide is made for audiences who seek to understand more about bottom-line accountability and use of evaluation data to improve future outcomes.

This book is geared toward a variety of functional areas in healthcare organizations where projects are implemented. These areas include (but are not limited to) projects in:

• Human resources, education, talent management

• Learning and development, performance improvement

• Technology, IT systems

• Medical meetings, events, and conferences

• Leadership, development, coaching

• Marketing, promotion

• Risk management, compliance

• Public relations, community affairs, government relations

• Quality, Six Sigma

• Operations, methods, logistics

• Case management

• Research and development, innovation

• Finance, control, accounting

• Procurement, distribution, supply chain

• Public policy projects

• Charitable projects

More than 3,300 individuals have become a certified ROI professional (CRP) through the ROI Institute. Although many books tackle accountability in a certain function or process, this book shows a method that works across all types of projects.