Assessment 1: Dashboard Benchmark Evaluation


Dashboard Benchmark Evaluation

In everyday health practice, health care practitioners and organizations work to achieve a set target. They commit their energy and resources to meet the desired levels of care quality and patient safety as legally, ethically and professionally required. To achieve the desired outcomes, health care providers are guided by performance benchmarks. From a health care perspective, dashboards serve as the most reliable analytic tools for monitoring key performance indicators. They contain metrics that enable health care providers to access crucial patient statistics and intervene approximately as areas of underperformance obligate. Based on the dashboard data for substance use disorder (SUD) at an emergency room (ER), this paper explains the implications of underperformance in key areas and the role of stakeholders in performance improvement.

Dashboard Metrics for CareM Medical Center (ER): Last quarter 2019

Area of Performance Status Target Compliance Percentage
SUD screening 450 400 100%
Waiting hour average 80 minutes 40 minutes 50%
Motivational interviewing for SUD 180 150 100%
Number of beds 10 20 50%
Nurse: patient ratio 1:5 1:4 80%

Hospital overview: CareM Medical Center is located in Bakersfield, California. Operating majorly in an under-resourced setting, the facility targets low-income earners. For a while, substance use disorder (SUD) has been a key focus area in the center’s emergency room. The data indicates areas of underperformance, implying that interventions are necessary to change the described state.

Evaluation: Metrics not Meeting Organizational Benchmark

Health care organizations must meet benchmarks set by local, state, or federal health care laws or policies. The targets indicated on the dashboard are quality performance standards that CareM Medical Center should strive to meet consistently. Based on this data, the metrics not meeting the benchmark include SUD screening, waiting hour average, number of beds, and nurse to patient ratio. It is a genuine concern considering the areas affected critically affect patient outcomes.

Health Care Policies Establishing the Benchmarks

Located in Bakersfield, CareM Medical Center is primarily regulated by California laws. The number of

Assessment 1 Dashboard Benchmark Evaluation

Assessment 1 Dashboard Benchmark Evaluation

patients served daily, referrals, and emergency care should follow California health law. It is also crucial to consider what federal policies recommend about the stated benchmark metrics. The average waiting time in an emergency room (ER) is forty minutes. The other area governed by law is the nurse to patient ratio in the ER. California recommends a ratio of 1:4 (Dembosky, 2020). The number of beds should be adequate to prevent overcrowding. From this evaluation, attention should shift to practices that can reduce waiting time in the ER. However, the evaluation could have been better if there was data to compare progress over time. For instance, data in the other three quarters in 2019 can help examine the progress to ascertain whether attention should be on reducing waiting time to meet the federal recommendations or other areas.

Challenges Associated with Meeting Prescribed Benchmarks

Meeting the prescribed benchmarks is always challenging from an organizational perspective. To ensure that patients are adequately served, health care providers and medical equipment must be sufficient. Interprofessional collaboration should be high enabled by modern health technologies, among other means. To achieve this, health care organizations must look for the necessary resources to address current and emerging needs. They are forced to search for operational and capital funding and invest resources to get the required financial resources. Support services must be plenty too. Since health care organizations are not investment-oriented, the inadequacy of resources usually hinders them from serving patients and the community as their strategic missions envisage.

Financial and operational challenges are central to the underperformance seen in staffing. For health care organizations to have the required number of health care providers, adequate financial resources are vital. Processes such as recruitment, motivation, and performance appraisal depend on financial resources. Salaries for the extra workforce and facilities such as accommodation are money-based. Accordingly, the nurse: patient ratio will depend on the organization’s resources to a considerable extent. Based on CareM’s setting, the nurse-patient ratio of 1:5 is sensible, albeit the need for improvement.

Benchmark with Great Impacts on Overall Performance

From the highlighted underperformance areas, the nurse: patient ratio in the ER can significantly improve overall performance. Nurse: patient ratio affects nurses’ productivity since it can deter their motivation and ability to work due to heavy workload if the ratio is too high (Gutsan et al., 2018). Overworking as nurses try to achieve the set benchmarks leads to nurse burnout. The nurse: patient ratio in the ER determines how nurses approach routine care without making medication errors. Handling a manageable number of patients allows nurses to work on patients quickly and avoid overcrowding in emergency rooms (Hawk & D’Onofrio, 2018). If not overwhelmed, nurses would also be better positioned to liaise with outside physicians to determine whether patients require emergency visits accurately.

Benchmark of Interest: Average Waiting Hour

Together with the number of beds, the average waiting hour is the benchmark I chose for improvement. In the medical center, the average waiting time is eighty minutes, double the allowable average of forty minutes. A review of the causes of high waiting time in emergency rooms revealed that beds’ inadequacy is a leading cause. The other reason is that medical facilities do not give outside physicians the privilege to admit patients, making ER visits higher than usual. Unless the issue of referrals is addressed, the situation is unlikely to change soonest to improve health outcomes.

Regarding the benchmark underperformance that is most widespread throughout the organization, the inadequate number of beds deserves a lot of attention. It is more of an administrative problem than a policy issue. A low number of beds implies that SUD patients cannot be released for admission and pave the way to screen other patients since they must stay in beds. Accordingly, this problem becomes the most impacting on patients and staff. To patients, the waiting time increases, risking their health further. It can be a source of demotivation to serve for nurses since the number waiting to be served is proportional to the waiting time.

Impacts of Underperformance on the Community

Ethically and professionally, health care organizations are mandated to provide excellent quality care and prioritize patient safety. High waiting time is a disservice to the community served and violates the principle of health care equity. According to Reese (2019), high waiting time in emergency rooms affects the health of millions of Americans yearly, and many usually leave health care facilities without attendance or partially attended.  This disservice is also a leading cause of more extended hospital stays since the chances of health complications as patients wait to be served are high. High waiting time increases medical errors and patients’ death rates (Martinez et al., 2019). As a result, the community health is affected adversely, and attention to enhance performance is necessary.

Opportunity to Improve the Overall Quality of Care

CareM Medical Center can prevent risking patients’ lives by addressing the issue of high waiting time. In the current setup, the best way to lower waiting is to ensure that the ER has adequate beds to accommodate more patients as they receive SUD services. If possible, administrative interventions to increase the number of registered nurses to match the State’s threshold are crucial. Doing so will ensure that nurses are more empowered and supported to serve patients irrespective of the increasing numbers.

Ethical Action

Health care facilities operate as they follow administrative and legal policies. Internal and external policies guide them, and violation of the set policies has severe legal and ethical implications. In the current setup at CareM Medical Center, a huge portion of the patients visiting the emergency room are referred by outside physicians. They (outside physicians) refer many patients to the ER since they are not professionally mandated to provide complete SUD care. Outside physicians lack admitting privileges. They cannot admit a patient directly, implying that almost all the medical center’s admissions come through the ER. Accordingly, it is crucial to increase outside physicians admitting privileges to reduce unnecessary visits to the ER. Visits to the ER should be reserved for critically ill patients.

Responsible Stakeholders

Stakeholders play a critical role in the running of health care facilities. Their decisions have huge implications on how an organization functions and policies made every day. To improve waiting time at CareM Medical Center, the best-positioned group of stakeholders is the quality service board. The board consists of the facility’s administration, and patients, community, and legal representatives. Its work is quality assurance and searching for resources to enhance performance, particularly donation. The board is also responsible for policy formulation to ensure that services meet the expected quality standards.

Importance of Action

Always, health care facilities should be concerned when their services fail to meet the desired benchmark. Underperformance has huge implications on the quality of care and patient safety, and interventions to match the legally and ethically set standards are imperative. When facilitated to serve, nurses will also be motivated to offer their services, and the chances of burnout will reduce. CareM Medical Center will also be safe from legal violations. Such interventions will enable the facility to continue serving the community diligently as its mission statement envisages.

Supporting Improved Benchmark Performance

The stakeholder group can apply several strategies to support improved benchmark performance. It can improve interprofessional collaboration between outside physicians and the ER nurses to prevent unnecessary ER visits. When outside physicians and ER nurses collaborate to assess a patient, physicians would be more empowered to admit patients directly without an ER visit. However, such a change in the work structure needs some policy formulations to advance the role of outside physicians that is somewhat limited.

In conclusion, quality health delivery is challenging when a health care facility is underperforming in some areas. Dashboard metrics are reliable reference points to determine whether a health care facility performs as the local, state, or federal laws obligate. CareM Medical Center’s close assessment shows that it needs to improve on nurse: patient ratio, average waiting hours, and the number of beds in the ER. Policy and administrative interventions to change the current state include giving outside physicians more admission privileges, increasing the number of nurses, and looking for financial resources to buy more beds in the emergency room.




Dembosky, A. (2020, Dec 30). California is overriding its limits on nurse workloads as COVID-19 surges. npr.

Gutsan, E., Patton, J., Willis, W. K., & PH, C. D. (2018). Burnout syndrome and nurse-to-patient ratio in the workplace. Marshall University.

Hawk, K., & D’Onofrio, G. (2018). Emergency department screening and interventions for substance use disorders. Addiction science & clinical practice13(1), 1-6.

Martinez, D. A., Zhang, H., Bastias, M., Feijoo, F., Hinson, J., Martinez, R., … & Prieto, D. (2019). Prolonged wait time is associated with increased mortality for Chilean waiting list patients with non-prioritized conditions. BMC public health19(1), 1-11.

Reese, P. (2019, May 17). As ER wait times grow, more patients leave against medical advice. KHN.

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Important information on Writing a Discussion Question

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  • Follow APA-7th edition
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