I have been considering my response seriously for the past two weeks and found out that I did not write this for vengeance or self-defense. Five months ago, our head office (international company) sent someone to our center and audited our center standards. Five months later, they came out with a performance review. 28 dialysis centers were audited and they were graded by one regional manager who is also the author of the review.
What I feel absurd is:
1. The benchmarking indicators used do not reflect the areas of service
2. There is no target value as the denominator in the score. The denominator was the value the assessor believed to be reasonable for that facility. (eg. My center scored 100% in MD involvement as my doctor only attends to patients once a week in a 30 mins. round)
3. The report is based on centralized, directive-based management.
4. There was no substantial or numerical measurement of the indicators. All the standards were subjectively rated in stead of objectively rated by one assessor.
5. Definitely there was bias among centers. All centers that are owned by our company but managed by different authorities scored 100% compliance.
And there are other issues like demographic difference etc. which have influences on the stats .
I am going to write to the head office which is thousand miles away from the place I work and cc to all other facilities and country managers and regional managers. Am I making it too big. I am in a dilemma, as I am leaving the company in two months time, but I don't want to waste time in filling up returns and stats that will only scare the patients and upset the staff in the whole region. I feel that I should speak up for the staff in my own center and other centers as well.
What do you think?
Feb 16, '03
Can I ask if your not doing it for vengence or self-defense why are you doing it? Did it reflect bad on your center or you? I am trying to figure out if your unhappy with the review you received or what you hope to accomplish?
Just need more information.
Feb 16, '03
It didn't reflect bad on my center. In fact, my center was rated as within normal standards and even some with 100% compliance. Our centers are new to the company. Among these 28 centers assessed, there are centers in different countries in Asia and with diverse cultural difference and social backgrounds. (ie. no. of hospitalization days does not reflect anything since the length of stay in different countries varies even for the same condition) The technique was simplistic and sloppy. I will say anyone can score higher if he knows how the game is played. The better you present yourself on the day of assessment, the higer score you will get. It was subjective and not evidence-based. It doesn't mean anything, excepts tons of paper work, monthly returns on something not relevant.