HOSPITAL DEPARTMENT PERFORMANCE EVALUATION USING THE PROMETHEE - - PowerPoint PPT Presentation

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HOSPITAL DEPARTMENT PERFORMANCE EVALUATION USING THE PROMETHEE - - PowerPoint PPT Presentation

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HOSPITAL DEPARTMENT PERFORMANCE EVALUATION USING THE PROMETHEE MULTICRITERIA METHODOLOGY Prof. Bertrand Mareschal Solvay Brussels School of Economics & Management, ULB bmaresc@ulb.ac.be Jim Ilunga, MD Europe Hospitals (St-Michel),

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June 2011 1

HOSPITAL DEPARTMENT PERFORMANCE EVALUATION USING THE PROMETHEE MULTICRITERIA METHODOLOGY

  • Prof. Bertrand Mareschal

Solvay Brussels School of Economics & Management, ULB bmaresc@ulb.ac.be

Jim Ilunga, MD

Europe Hospitals (St-Michel), Brussels

  • Prof. Sarah Ben Amor

Telfer School of Management, University of Ottawa

INFORMS Healthcare

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June 2011 2

Summary

  • 1. The problem.
  • 2. A multicriteria approach with the

PROMETHEE & GAIA methods.

  • 3. Descriptive analysis.
  • 4. Performance ratios analysis.
  • 5. Global performance measurement.
  • 6. Conclusions & Developments.

INFORMS Healthcare

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Objective

  • Compare different hospital departments

based on activity and resources usage (data availability):

– Administrative staff, paramedics, equipment, surface. – Turnover, net result, fees.

  • Evaluate the relative performance level
  • f the departments.

June 2011 INFORMS Healthcare 3

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Data

  • Annual data (2008) for two Brussels

hospitals: (Europe Hospitals group, 716 beds)

– St-Michel hospital – Ste-Elisabeth hospital

  • 31 departments.

June 2011 INFORMS Healthcare 4

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A multicriteria approach

  • Why?

– Several evaluation criteria to aggregate.

  • Multicriteria Decision Aid (MCDA):

– Compare and assess several actions that are evaluated on several criteria.

  • Multicriteria model:

– Actions: departments. – Criteria: activities, resources, ratios.

June 2011 INFORMS Healthcare 5

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June 2011 6

PROMETHEE & GAIA methods

  • Outranking methods.
  • Pairwise comparison of actions.
  • Closer to the decision problem.
  • Simple preference modeling:

– Preference functions (scales), – Weights (priorities).

  • Prescriptive and descriptive:

– PROMETHEE: ranking, net flow score, – GAIA: visual representation of actions and criteria.

INFORMS Healthcare

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  • 7 criteria:

– 4 input criteria (resources) – 3 output criteria (activities)

  • 2 dimensional representation with as much

information as possible on what differentiates the departments.

  • Departments: points

– Similarities

  • Criteria: axes

– Conflicts

GAIA descriptive analysis

June 2011 INFORMS Healthcare 7

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Performance analysis

  • 6 criteria: performance ratios

(output/input):

– Turnover/m2 – Turnover/staff – Turnover/equipment – Result/m2 – Result/staff – Result/equipment

June 2011 INFORMS Healthcare 9

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Performance analysis

June 2011 INFORMS Healthcare 10

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Focus on 7 “med-tech” departments

  • Nuclear and molecular imaging (SE – SM)
  • Anatomopathology
  • Laboratory
  • Radiology (SE – SM)
  • Physiotherapy

June 2011 INFORMS Healthcare 11

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June 2011 INFORMS Healthcare 12

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Nuclear and molecular Imaging

June 2011 INFORMS Healthcare 13

Ste Elisabeth hospital St Michel hospital

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Surgery

June 2011 INFORMS Healthcare 14

Ste Elisabeth hospital St Michel hospital

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Internal Medicine

June 2011 INFORMS Healthcare 15

Ste Elisabeth hospital St Michel hospital

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Global Performance Measurement

  • Based on PROMETHEE net flow score for

two groups of criteria:

– “Input” criteria (resources): f IN – “Output” criteria (activities): f OUT

  • Multicriteria performance index:

June 2011 INFORMS Healthcare 16

     

max

1 1 1

OUT IN

a MPI a MPI a f f    

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Multicriteria Performance index

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

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“Input-Output” analysis

  • 2 dimensional graphical representation of

the departments.

  • “Efficient” departments and “efficient”

frontier.

  • Determination of “reference”

departments for improving the performance of non-”efficient” deparments: goals.

June 2011 INFORMS Healthcare 18

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June 2011 INFORMS Healthcare 19

Med N SM Med N SE Chir SE Chir SM

  • 1,00
  • 0,80
  • 0,60
  • 0,40
  • 0,20

0,00 0,20 0,40 0,60 0,80 1,00

  • 1,000
  • 0,800
  • 0,600
  • 0,400
  • 0,200

0,000 0,200 0,400 0,600 0,800 1,000

X: resources - Y: output

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Conclusion and Future

  • Multicriteria approach to performance

evaluation:

– Preference modeling: priorities (weights), sensitivity analysis (how to improve performance), – Visual representations (decision aid).

  • Future developments:

– Other evaluation criteria. – Other fields of application. – Software development.

June 2011 INFORMS Healthcare 20