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36. KPI in All Industries

36.8 Healthcare

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Hospital and clinic interviews ask bed occupancy, average length of stay (ALOS), and whether appointments were actually seen. Footfall on a poster is not a KPI. This is a fictional trust, not a named hospital's result.

KPI What the number means Who uses it Action it drives
Occupancy Patient-days divided by beds times days in the period. Medical superintendent High occupancy with a long stay is blocked beds, not "success".
ALOS Patient-days divided by discharges. Ward in-charge A rising ALOS on the same ward is a discharge-planning problem.
Show-up % Appointments seen divided by appointments booked. OPD manager No-shows are a call list. Do not add a doctor for patients who did not come.

Fictional sample rows. One week (7 days).

Ward City Beds Days Patient-days Discharges Appointments Seen
General Pune 20 7 112 28 200 160
Maternity Pune 10 7 56 14 80 70
General Nashik 16 7 98 20 120 110
Children Nashik 8 7 28 10 60 40
General Kolhapur 12 7 42 8 90 50
General Nagpur 18 7 100 16 140 120

Worked from those rows.

  • Patient-days 436. Bed-days are (20+10+16+8+12+18) × 7 = 84 × 7 = 588. Discharges 96. Appointments 690. Seen 550.
  • Occupancy is 436 ÷ 588 = 74.1%.
  • ALOS is 436 ÷ 96 = 4.54 days.
  • Show-up is 550 ÷ 690 = 79.7%.

Pune general: occupancy 112 ÷ (20×7) = 112 ÷ 140 = 80.0%. ALOS 112 ÷ 28 = 4.0 days. Show-up 160 ÷ 200 = 80.0%. Nashik children: occupancy 28 ÷ (8×7) = 28 ÷ 56 = 50.0%. Show-up 40 ÷ 60 = 66.7%. ALOS 28 ÷ 10 = 2.8 days.

Good KPI Vanity metric
From the same rows Nashik children show-up 66.7% and occupancy 50.0% Pune general 200 appointments
Why Twenty of sixty Nashik children did not come. The ward is half empty. Pune's appointment card is the largest. Forty of those 200 also did not come, which the card hides.

What the manager does. The Nashik manager calls the 20 missed children's appointments before asking for more beds. The Pune superintendent does not add a general-ward bed this week: occupancy is 80% and ALOS is 4 days, which is the planned stay in this file. The 40 Pune no-shows are a phone list, not a construction plan. Kolhapur general show-up is 50 ÷ 90 = 55.6% and occupancy is 42 ÷ 84 = 50.0%. Same action, different city.

Ravindra Bagale's Tip

A common mistake is calling "patients today divided by beds" the occupancy and forgetting patient-days. A week's number must be divided by beds times days. Otherwise one Sunday shift becomes the whole month. Remember this rule.