Success Story - University Children's Hospital Basel (UKBB)

The customer

As one of three independent children's hospitals in Switzerland, the University Children's Hospital Basel (UKBB) plays a key role in ensuring cantonal, regional and supra-regional child and adolescent medical care. Every year, around 6,000 young patients are treated as inpatients and 115,000 as outpatients. Over 1,000 employees - including around 240 doctors and 415 nursing staff - provide the paediatric care.

HEALTH SYSTEM IN TRANSITION

The Swiss healthcare system is changing rapidly. Digitalization is advancing rapidly and will have a massive impact on the next few years. New legal requirements and increasing economic pressure on hospitals will lead to further concentration of hospitals. The University Children's Hospital Basel (UKBB), an independent university competence centre for child and adolescent medicine as well as for teaching and research, is also located in this field of tension. 

The UKBB would like to actively shape change in the healthcare system and position itself as a strong healthcare provider and research location in the long term. Digitalization plays a crucial role here. This is especially true when it comes to focusing on patients and at the same time working as efficiently as possible.  

MIS based on Qlik and SAP 

UKBB has been using a management information system based on Qlik Sense since 2018. ‘The decisive factor in choosing Qlik was the flexibility and performance in reporting as well as the visits to reference sites in which we were able to see Qlik Sense in action live,’ remembers Robert Kopf, controller and deputy head of finance at UKBB. 

Data from the SAP system connected via Qlik Connector with the FI-CO, IS-H and HR modules are evaluated. The data visualization takes place in various reports; The design is tab-orientated, so users can navigate the dashboards in a similar way to web pages.

The inpatient reporting is shown with information on care days, discharges, bed occupancy and length of stay in days as well as the respective deviation from the previous year and the budget with the corresponding deviation from the previous year. 

DRG reporting includes ten different dashboards on aspects such as CaseMix, exits, coding status, case analyses, invoiced cases, etc.

The application for outpatient reporting focuses on the sum of tax points, the number of visits and the number of cases. Performance reporting and personnel reporting are also available, which use the same principle to provide key figures via a dashboard as well as further information via various data sheets. 

The data of all reports can be viewed from different perspectives such as year, period and station, case number, etc.

With Qlik Sense, a Rekole-compliant cost centre report was also created, in which cost types and activity quantities as well as statistical key figures and individual items can be accessed.

The DRG cost object reporting includes mapping of the DRG data in around 50 dimensions as well as options for evaluating DRG data enriched with case information.

An integrated manual ensures that around 50 users can learn to use the applications at any time. ‘We want to be transparent. This also means that, with a few exceptions, we will make the numbers available to everyone. And we will do this without a complex authorization concept and in a form that is easy and quick to consume. Because doctors and nursing staff should be able to spend their time primarily on patients,’ says Robert Kopf.

The finance department uses Qlik Sense to retrieve account statements from SAP for controlling third-party funded research projects.

UKBB implemented the project with Informatec. ‘We were convinced by Informatec’s clear focus on consulting and implementing needs-based business intelligence solutions – also in the area of medical controlling – and the comprehensive Qlik expertise,’ says the controller. ‘Another factor for us was the spatial proximity: We wanted a Qlik partner who was also physically at our side.’ 

Challenge: Performance Monitoring 

In a next step on the way to becoming a ‘ Digitally Driven Hospital’, the UKBB wanted to establish a cost centre cockpit that intelligently brings together performance and personnel reporting in order to monitor and control performance in various areas. Because patient orientation also means acting economically in order to use the available resources in the best possible way in the interests of the patients. ‘Our goal is to use resources more efficiently,’ says Lukas Erb, CFO at UKBB. ‘We deliberately wanted to involve the service providers responsible for the area - primarily from the medical and nursing professions - to a greater extent in the responsibility for economic service provision.’

After the order was placed by the board of directors, the CFO and controlling, together with the CEO, the medical director and a specialized consulting company first defined a system of productivity indicators for measuring performance and setting goals in the various departments.  

The UKBB then worked with Informatec to develop a preliminary, conceptual version of a corresponding key figure cockpit in Qlik Sense and then implemented the actual solution. Informatec's mock-up served as a guide throughout the development process. This ensured that both the functions and the design of the cockpit met the requirements of the UKBB. ‘We also tested the cockpit in two pilot areas’ adds Robert Kopf. 

PERFORMANCE MONITORING WITH A COST CENTRE COCKPIT 

After around six months of development, the cockpit was put into production. In an entry-level dashboard, central KPIs for the outpatient and inpatient areas are now available in an overall overview. The data can be filtered according to the viewing period. For the outpatient sector, tax points - the common unit of measurement in Switzerland for calculating remuneration for outpatient services - and minutes per full-time employee (Full Time Equivalent / FTE), the values of the previous year and the corresponding deviation as well as the agreed target values and the deviation from the actual values are shown.

In the inpatient segment, the key figure ‘CM calculated’ is the main focus. Robert Kopf expounds: ‘The services provided by a ward can be measured by the days of care provided. However, a simple CaseMix does not take into account the differences in the severity of the illnesses or in the individual needs of the patients. A person with multiple chronic illnesses and complications may require more resources and treatments than a person with a single illness. We also wanted to display the severity level in the cost centre cockpit. For this reason, the CaseMix of the person treated is included in the calculation in the CM key figure. The key figure is defined as the quotient of the case mix per day of care and the product of the days of care in these cases and the days of care provided in the respective ward.’

The current calculated case mix per full-time employee and the previous year's value are presented and compared - each for the medical profession dimension and for the nursing dimension. In addition, the target value is displayed with deviations from the actual value. 

In addition to the overall overview, the cost centre cockpit offers deeper insights and analysis options via detail sheets. The services, the necessary input factors and the resulting key figures are presented. The key figures and target variables can be viewed from a medical and nursing perspective for different time periods (year, month, quarter) and from the perspective of the performance unit, the personnel category, the areas of responsibility such as surgery, orthopaedics, oncology, etc. and the cost centre. In addition to ‘previous year’ and ‘target comparisons’, the ‘five-year development’ is also displayed to enable a trend analysis. For quick comprehension, the numbers are presented graphically in the form of diagrams.

For example, the number of visits by individual patients, the tax points or minutes per FTE and the number of FTEs are shown. The costs per tax point or minute as well as personnel and material costs are also shown - down to the cost type level.

Similarly, the detailed view for the inpatient area provides information on the care days and the calculated case mix per FTE, the number of FTEs as well as personnel and material costs in total and per calculated case mix.

The responsible service providers can also see how many FTEs were planned for the cost centre, how much was actually used and any deviations from the budget.

TRANSPARENCY AND CONTROLLABILITY  

The greatest added value for the UKBB lies in the newfound transparency for management and those responsible for medicine and nursing: The cost centre cockpit not only enables the monitoring and control of cost developments in the various departments, but also the targeted control of the productivity of the individual areas. In order to ensure that realistic and relevant goals are set that correspond to the requirements and goals of the hospital, the goals were defined by management together with those responsible for the service areas. By visualizing the deviation of the actual values from the agreed target values per full-time employee, those responsible for the area can see at a glance whether they are on target or not. The detailed views allows them and the management to identify the causes of undesirable developments and specific levers to counteract this trend.

‘Because we involve those responsible for the area in setting goals, they can personally identify with the goals and are motivated and committed to achieving them,’ adds Lukas Erb. ‘Through their direct participation in the annual review discussions and redefining goals for the following year, a better understanding of the hospital's strategic priorities and challenges develops. We are working more closely together to make the UKBB one of the leading university-based national centres for child and adolescent medicine. And we do so with great competence and humanity.’

The hospital no longer wants to do without Qlik Sense, emphasizes Robert Kopf. ‘We are very satisfied with the solution and have a whole range of other projects that we would like to tackle together with Informatec in the coming years. Examples include the integration of PEP, data from radiology and the laboratory as well as OPS and anaesthesia data from our hospital information system.’