hospital department performance evaluation
TRANSCRIPT
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HOSPITAL DEPARTMENT HOSPITAL DEPARTMENT
PERFORMANCE EVALUATION USING PERFORMANCE EVALUATION USING
THE PROMETHEE MULTICRITERIA THE PROMETHEE MULTICRITERIA
METHODOLOGYMETHODOLOGY
June 2011 1
Prof. Bertrand MareschalSolvay Brussels School of Economics & Management, ULB
Jim Ilunga, MDEurope Hospitals (St-Michel), Brussels
Prof. Sarah Ben AmorTelfer School of Management, University of Ottawa
INFORMS Healthcare
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SummarySummary
1. The problem.
2. A multicriteria approach with the PROMETHEE & GAIA methods.
3. Descriptive analysis.
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3. Descriptive analysis.
4. Performance ratios analysis.
5. Global performance measurement.
6. Conclusions & Developments.
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ObjectiveObjective
• Compare different hospital departments
based on activity and resources usage
(data availability):
– Administrative staff, paramedics, equipment, – Administrative staff, paramedics, equipment,
surface.
– Turnover, net result, fees.
• Evaluate the relative performance level
of the departments.
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DataData
• Annual data (2008) for two Brussels
hospitals:
(Europe Hospitals group, 716 beds)
– St-Michel hospital– St-Michel hospital
– Ste-Elisabeth hospital
• 31 departments.
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A multicriteria approachA multicriteria approach
• Why?
– Several evaluation criteria to aggregate.
• Multicriteria Decision Aid (MCDA):
– Compare and assess several actions that are – Compare and assess several actions that are
evaluated on several criteria.
• Multicriteria model:
– Actions: departments.
– Criteria: activities, resources, ratios.
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PROMETHEE & GAIA PROMETHEE & GAIA
methodsmethods• Outranking methods.
• Pairwise comparison of actions.
• Closer to the decision problem.
• Simple preference modeling:
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• Simple preference modeling:– Preference functions (scales),
– Weights (priorities).
• Prescriptive and descriptive:– PROMETHEE: ranking, net flow score,
– GAIA: visual representation of actions and criteria.
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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
GAIA descriptive GAIA descriptive analysisanalysis
• 2 dimensional representation with as much information as possible on what differentiates the departments.
• Departments: points– Similarities
• Criteria: axes– Conflicts
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Performance analysisPerformance analysis
• 6 criteria: performance ratios
(output/input):
– Turnover/m2
– Turnover/staff– Turnover/staff
– Turnover/equipment
– Result/m2
– Result/staff
– Result/equipment
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Performance analysisPerformance analysis
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Focus onFocus on
7 “med7 “med--tech” departmentstech” departments
• Nuclear and molecular imaging (SE – SM)
• Anatomopathology
• Laboratory• Laboratory
• Radiology (SE – SM)
• Physiotherapy
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Nuclear and molecular Nuclear and molecular
ImagingImaging
Ste Elisabeth hospital St Michel hospital
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SurgerySurgery
Ste Elisabeth hospital St Michel hospital
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Internal MedicineInternal Medicine
Ste Elisabeth hospital St Michel hospital
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Global Performance Global Performance
MeasurementMeasurement• Based on PROMETHEE net flow score for
two groups of criteria:
– “Input” criteria (resources): φ IN
– “Output” criteria (activities): φ OUT– “Output” criteria (activities): φ OUT
• Multicriteria performance index:
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( ) ( )( )max
11
1
OUT
IN
aMPI a
MPI a
φφ
+= ×
−
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Multicriteria Performance Multicriteria Performance
indexindex
60%
70%
80%
90%
100%
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0%
10%
20%
30%
40%
50%
60%
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“Input“Input--Output” analysisOutput” analysis
• 2 dimensional graphical representation of
the departments.
• “Efficient” departments and “efficient”
frontier.frontier.
• Determination of “reference”
departments for improving the
performance of non-”efficient”
deparments: goals.
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Med N SM
Med N SE
Chir SE
Chir SM
0,00
0,20
0,40
0,60
0,80
1,00
X: resources - Y: output
Med N SM
Med N SE
Chir SE
Chir SM
0,00
0,20
0,40
0,60
0,80
1,00
X: resources - Y: output
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-0,80
-0,60
-0,40
-0,20
0,00
-1,000 -0,800 -0,600 -0,400 -0,200 0,000 0,200 0,400 0,600 0,800 1,000
-1,00
-0,80
-0,60
-0,40
-0,20
0,00
-1,000 -0,800 -0,600 -0,400 -0,200 0,000 0,200 0,400 0,600 0,800 1,000
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Conclusion and FutureConclusion and Future
• Multicriteria approach to performance evaluation:– Preference modeling: priorities (weights), sensitivity analysis (how to improve performance),performance),
– Visual representations (decision aid).
• Future developments:– Other evaluation criteria.
– Other fields of application.
– Software development.
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More More resourcesresources……
• Software integration:
– PROMETHEE Software → Free Preview
download:
www.promethee-gaia.net/software.htmlwww.promethee-gaia.net/software.html
• PROMETHEE & GAIA:
– Web site: www.promethee-gaia.net
– Blog: blog.promethee-gaia.net
– Forum: forum.promethee-gaia.net
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