As president of Oregon-based skilled nursing operator Avamere Living, Carl Tabor brings many years of experience managing clinical operations in a variety of health care settings. Tabor worked as an RN for many years before coming a licensed nursing home administrator and still carries an active RN licensure today. His work as a nurse led to his roles as a director of nursing services, then administrator, then other regional support roles before taking the job as VP of Clinical with Avamere, before taking on his current leadership position.
In this Clinical Dashboard series interview, Tabor shares details on what his ideal clinical dashboard looks like, why almost everyone in the care organization can benefit from such a dashboard, and why a dashboard is only as good as the data it pulls.
Skilled Nursing News: What are the three most important data points that you would want to see each day on your ideal clinical dashboard?
Carl Tabor: It depends on the role. Looking at data from a multi-facility management lens is very different than a single facility. I prefer to look at process indicators, leading indicators, and outcomes. For example, if I believe completion of an assessment and care plan are keys to pressure injury prevention, then the rates of completion of those processes would be on my dashboard versus actual numbers of nosocomial pressure injuries. For my relationships with payors, I need to know hospitalization rates, emergency room visits and length of stay in comparison with cost of care and total reimbursement.
How would the ideal clinical dashboard drive patient care decisions?
I think a dashboard is only as good as the data it pulls. If I have a dashboard that accurately reflects patient acuity, I then can manage my resources to high-risk areas in support of improving patient outcomes. I believe as predictive analytics and AI are further developed, those types of dashboards will be more meaningful.
How would the ideal clinical dashboard help optimize reimbursement?
Real-time calculations based on data that has some type of logic built into it, so that a facility can specifically evaluate data that will drive reimbursement. I also think there are opportunities to develop dashboards that monitor and predict quality enhancements, case mix (for those case mix states), and help manage length of stay and discharge planning.
How can the clinical dashboard improve staffing efficiency?
I think it revolves around determining staffing for peak care times and allocation of resources. I’m curious to explore staffing patterns that are atypical but provide additional resources around key care delivery times such as medication administration, activities of daily living, treatments, etc. I think given labor resources the operators that figure out staffing efficiencies will thrive.
How would you like to see the clinical dashboard integrated with predictive analytics tools?
There have been many platforms that take data, usually based on MDS completion, that tout predictive analytics. However, I found that many of those fall short — in part due to the age of the data and inability to separate patients by significant risk. For example, a fall risk assessment that identifies a majority of our patients as at-risk for falls isn’t helpful. I think as AI evolves and electronic health records advance there will be greater ability to identify not only patients at risk, but also specific interventions based on the identified risk.
Besides yourself, what are the most important roles in your organization to also have access to the clinical dashboard?
I think every clinical position from a nursing assistant to VP of Clinical as well as operators (administrator, regional) have an opportunity to improve clinical outcomes, staff and patient satisfaction, and ultimately improve financial outcomes by using dashboards and data to inform decision-making. There are very few roles that couldn’t benefit from understanding data points on the appropriate dashboards. I would caution that at times there are too many dashboards that are not integrated or used appropriately and then it can be overwhelming to determine which dashboard is most effective.
What would you do to improve the collection of patient health data?
There needs to be one integrated national database that collects data. Health care is too fragmented and clinicians need the entire health history to adequately make informed decisions.
