On a monthly basis, the Department of Anesthesiology’s administrative team processes Additional Pay and On-Call Payments for around 150 faculty members, totaling over $7,000,000 annually. The data used to derive these payments comes from a variety of sources, ranging from our third-party call schedule system (QGenda), to UPI Collections, to time-tracking spreadsheets, to the Epic documentation used at the University of Colorado Hospital (UCH).
The Department of Anesthesiology’s Information Systems team, along with input from a number of collaborators representing administrative and faculty leadership, developed an ‘Incentive Application’ system to record and track all of these data points. Most data points are automatically synced with the source systems described above, which includes tracking all of the dollar amounts associated with each type of element. The Incentive Application automatically downloads and categorizes over 20 different types of calls an individual can take during any given month and applies the appropriate dollar amount associated with each call. The application also automatically syncs with the UCH Epic Clarity database to calculate charting compliance across seven different metrics for each anesthesia provider and the appropriate payment for each individual based on their own compliance and Clinical FTE.
How does this impact the University?
The application has reduced the amount of time required by administration to calculate the monthly incentives from around a week to just a few hours spent in verification. Additionally, in coordination with the SOM Deans Office, the Additional Pay Forms required by Human Resources have been modified from one PDF form per individual, requiring three separate approval signatures per form for approximately 100 unique forms, to one, single form containing all information required to complete the additional pay process (see attached spreadsheet for an example). This interdepartmental collaboration not only saves time for members of the Department of Anesthesiology, but for the Director of Faculty Affairs in the SOM Dean’s Office, and payroll approvers in Human Resources.
Another impact of note takes into account the new HCM system. With the implementation of HCM and the new requirement of entering all payments via batch upload, we have modified the Incentive Application to automatically generate a comma-separated value (csv) form for uploading into HCM. This has substantially reduced the amount of time of manual entry from a number of hours to just a few minutes, while also removing some risk for data entry errors.
One of the most notable features of the Incentive Application is the secure web-based portal, accessed via Department intranet, available to all faculty members who receive additional pay. This portal shows YTD payments, the calls and productivity metrics associated with each payment, as well as their current discretionary fund balance (see attached spreadsheet for an example). This portal is also the site for administrators to do any data-entry or reporting on the backend. The reporting functionality of the Incentives Application has enabled administrative staff to instantly report on over 150 faculty members’ compensation for specific time periods, facilitating improved benchmarking, allowing for immediate evaluation of quality and productivity, and empowering faculty to independently analyze their compensation and areas where they may have opportunity to improve their performance.
Outside of the incredible time savings and efficiencies created for administrative staff members (essentially, one quarter of the year was previously spent on this process – now, one day per month), the new application has facilitated the direct incentivizing of pre-determined quality and productivity metrics for faculty members working in the UCH ORs. This, in turn, has the potential to have a positive impact on patient care, with the goal of improving quality for all patients who may be touched by Anesthesiology services at the University of Colorado Hospital.
The Incentives Application has been in use for over two years within the Department of Anesthesiology. The application was first rolled out to Adult Physician faculty for pilot testing, and only reported on call payments. Once the system was up and running, the application was broadened to include Advanced Practice Providers call payments, and eventually expanded to report on salary, discretionary funds, and additional pay (a distinct pay type from call pay).
Currently, the application undergoes constant updates and revisions as new systems arise (i.e. change in call schedule system or implementation of HCM). The system also is updated with new reports as different ways to see how much money is being spent in each area of the department’s incentive/call payment sections. Plans for moving forward include incorporating residents who receive book funds from the Department along with call pay for additional hours worked, and eventually expanding to include physician and advanced practice provider faculty in Pediatric Anesthesiology. Once completed this, application will be available to over 300 department members across the entire Department of Anesthesiology.
Submitter's Name: Ken Bullard
Submitter's Email: firstname.lastname@example.org
Additional Team Members: Sean Clifford, Tasha Mitchell, Kirstin Runa, Carlos Fernandez