Productivity In Pediatric Palliative Care: Measuring And Monitoring An Elusive Metric

Productivity In Pediatric Palliative Care: Measuring And Monitoring An Elusive Metric

Kaye EC; Abramson ZR; Snaman J; Friebert S; Baker J

Journal Of Pain And Symptom Management

2017

CONTEXT: Workforce productivity is poorly defined in healthcare. Particularly in the field of pediatric palliative care (PPC), the absence of consensus metrics impedes aggregation and analysis of data to track workforce efficiency and effectiveness. Lack of uniformly measured data also compromises the development of innovative strategies to improve productivity and hinders investigation of the link between productivity and quality of care, which are interrelated but not interchangeable. OBJECTIVES: To review the literature regarding the definition and measurement of productivity in PPC; to identify barriers to productivity within traditional PPC models; and to recommend novel metrics to study productivity as a component of quality care in PPC. METHODS: PubMed(R) and CDSRa searches for scholarly literature were performed using key words1 for articles published between 2000-2016. Organizational searches of CAPC,b NHPCO,c NAHCH,d AAHPM,e HPNA,f NQF,g and NCPQPCh were also performed. Additional semi-structured interviews were conducted with directors from seven prominent PPC programs across the United States to review SOPsj for PPC team workflow and productivity. RESULTS: Little consensus exists in the PPC field regarding optimal ways to define, measure, and analyze provider and program productivity. Barriers to accurate monitoring of productivity include difficulties with identification, measurement, and interpretation of metrics applicable to an interdisciplinary care paradigm. In the context of inefficiencies inherent to traditional consultation models, novel productivity metrics are proposed. CONCLUSIONS: Further research is needed to determine optimal metrics for monitoring productivity within PPC teams. Innovative approaches should be studied with the goal of improving efficiency of care without compromising value.

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