Bob Luttman, Robert Luttman & Associates
(Briefly) Revisiting VMS Design Issues
Gateway Documentation - Normal Days
Gateway Documentation - Insert Days
Gateway Analysis
Variance Analysis Using Gateway Variables
Gateway variances facilitate care management and improvement from the bedside to the boardroom:
- A gateway variance indicates a clear and significant departure from the care process defined in the pathway. The patient may only temporarily deviate from the pathway, but their is no doubt that they have deviated. The gateway documentation then clearly communicates the variance, its cause, and future care plans to the entire care team.
- Collecting and reporting gateway data is easier and quicker. Gateway databases have existed manually in case manager's pockets, in computer spreadsheets, and in more elaborate computer database systems. The data is also amenable to simple graphical and statistical analysis which every care team member can perform.
- At higher levels of the organization aggregated gateway data illuminates key issues in care processes. This helps the organization focus its improvement resources (which are not infinite) on highly leveraged projects.
- At every level gateway variances answer the So What question, making it easier to engage others in improvement efforts.
Because Gateway variances identify "problem" patients they are also the key link between process and outcomes:
- The care team can assess the effect of gateway variances for its patient population
- The care team can perform root cause analysis on gateway variances on smaller more clearly defined patient populations.
This analysis all begins with the Gateway Report........
