Key Performance Indicators or KPI are an almost universal tool to help you manage your business, clinic, laboratory.
At its most simple, it is a piece of information about your work that you repeatedly measure to check if it is changing or remaining constant. Every type of organization or business will keep some KPI. They are used by all levels of management to confirm every thing is working as it should and to provide timely warning if it is not. Examples might be number of units produced/month, average cost per man hour worked, revenue/item etc.
OK but how does this relate to an IVF laboratory. If you clinician thinks there are fewer pregnancies in recent times, the first thing they will do is blame the laboratory. Now the Lab may well be the cause of fewer pregnancies but it may well also be other factors external to the lab. How do you respond?. With your KPI data. Actually it is better if you supply the clinicians with your basic KPI data regularly, it stops them from even asking the question!.
More practically though, you should use your KPI data each month to check that the basic embryology is constant e.g. the fertilization rate is the same, the number of embryos transferred is constant etc. This is done each month as a first line warning of possible problems. Calculating the implantation rate needs a bit more time.
Examples of KPI. At a basic level your KPI tool kit should contain information on the number of cases and the number of pregnancies each period. The period can be daily, weekly, monthly, quarterly biannually or at the very, very least annually. Most labs use a monthly KPI interval.
An expanded toolkit could include KPI such as:
Number of oocytes
Number of two Pronuclear embryos [fertilization rate]
How do I use the KPI when I collect them? The best way is to plot then out each month and see if there is any trends that look unusual e.g. if the number of eggs were increasing, then this may mean a doctor has changed the stimulation regimen which in turn may produce more OHSS cases, mean more work in the lab and change the embryology statistics etc.
The next step is to calculate the mean and standard deviation over the last 12 months or so and them use this information to determine if one months data is just a spurious outcome and your should not be too worried. The mean and SD can be used to create warning and action responses such that any result e.g. a fertilization outcome hat is more than 2SD form the previous mean should trigger an investigation. IVFBenchmark.com does these automatically but you can do these on your own PC using Excel etc.
How is an IVF laboratory different from a car manufacturer? In some ways it is the same and in others ways it is miles apart.
Both industries need to micro manage their factory floor. In IVF you need to check for failed fertilization, poor egg recovery or poor embryology almost on a daily basis. Your observations can be compared to your KPI data to let you know if any untoward event is random or due to staff or technical issues.
On a broader scale, if you are measuring oocytes/collection or pregnancy, then there are many factors ( almost all the possible factors) outside the laboratory that may cause variations. Age of the patient, BMI, previous experience, etc are the most common. But one cannot simply assume these are the cause. The first response is to consider the laboratory is the problem. Only by reviewing your KPI data can you feel confident that the causes may be elsewhere. Indeed, if your KPI data-set includes patient variables e.g. the proportion of women <35 to women>40+ , then you may quickly be able to identify a problem to have patient origins. The problem with IVF is the many factors than can influence the pregnancy rate and that the final measure (pregnancy) occurs a long time after the process (collection and transfer).
This raises a further consideration about KPI. That is they ned to be relevant and focused. For instance, if you were measuring oocytes/collection, then you may consider having a benchmark KPI series say for women < 35 years of age on their first cycle. If his KPI is constant and the overall KPI is changing, then this suggests other factors since if the quality in the lab has decreased, the benchmark KPI would also have changed.
Most clinics have a benchmark cohort, usually <35 years of age as the internal reference KPI.
The final aspect is that some KPI should always be collected but others may be transient. For instance, if you thought a stimulation regimen as causing more abnormal oocytes then you may create a KPI for # of oocytes with degenerative centers or # immature oocytes/ICSI to address this question. After a period of time, the KPI can be reviewed and if there is no difference, the KPI can be discontinued.
Welcome to FertAid - where quality Matters
IVF PROFESSIONAL DEVELOPMENT
- IVF Benchmarking
Allow clinics to plot key performance indicators over time. Access is Free
Many countries have an internal auditing of key activities eg pregnancies etc. However, there is no facility to benchmark a clinics activity against other clinics. The BenchMarking function in FertAid allows you to select from a list of KPI, and add monthly data.
Links to recent articles and publications, IVF daily aims to keep you update with new reports and comments
While it is impossible these days to keep abreast of all new publications, IVF daily aims to highlight recent reports that maybe of interest to you in your work either with patients or in the laboratory
IVFCDP aims to help you complete tasks that are both educational and contribute to your CPD points
The modules allow you to actively participate in e-learning in a general manner but also for active professional development where the modules are designed for accruing CPD hours/points. The topics are focused on both laboratory and nursing/counseling staff.