Metrics that move the needle

By Dr. Tony Briningstool, CEO, Sound Emergency Medicine, and Dr. Mihir Patel, CEO, Sound Hospital Medicine

In a hospital, change happens through measurement—not chance. Leaders must focus on the right metrics to improve clinical performance and drive sustainable results. National staffing and financial challenges, clinician burnout, and siloed teams can cause insufficient throughput, impacting the entire hospital. Poor performance can lead to lost referrals and eroded patient trust, which is why we partnered with Becker’s Healthcare to help leaders identify key drivers of success, understand critical operational, clinical, financial, and cultural metrics, and apply actionable strategies that foster alignment, accountability, and lasting impact.  

If everything is a metric, nothing is a priority   

Everything in a hospital is tracked—and we do mean everything.  As leaders and healthcare decision makers, it’s easy to become overwhelmed by the magnitude of metrics and data that come our way each day. This laundry list of numbers could be causing more distraction than action, and data alert fatigue can leave teams feeling hopeless and wondering where to begin.   

Don’t let metrics distract you from your intentional actions. It’s critical to ensure that our efforts support caregivers and equip our teams with tools, resources, and information that help them practice medicine more efficiently and care for patients more easily.  

Operational metrics: A solid foundation   

Operations are the front door to every other hospital domain, and resolving bottlenecks there drives improvements in clinical, financial, and cultural outcomes. Many patient experience and financial challenges stem from inefficiencies in flow—such as slow admissions, delayed discharges, bed-turnover lags, and limited visibility. While leaders may monitor dozens of key performance indicators (KPIs), a focused set of operational throughput metrics tied to team collaboration and organization consistently predicts overall system performance.  

• ED arrival-to-provider time    

• ED boarding time    

• Admission decision-to-bed time  

• Timeliness of discharge    

• Length of stay (LOS) index   

Ultimately, focusing improvements on the processes that drive the right outcomes for our leading metrics will inherently elevate all subsequent metrics. Manual tracking dashboards, bottleneck-free escalation pathways, and unit-level daily huddles are just some of the operational process improvements leaders can add to their teams’ toolkits to tangibly improve metrics.   

Clinical metrics: Standardizing the scorecard system   

Not all clinicians or health systems are created equally. By standardizing a scorecard for hospitalists that combines both clinical and operational metrics, organizations can create a clearer and more cohesive way to evaluate performance. Helpful data to track on these scorecards includes:   

• LOS   

• Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores   

• Readmissions   

• Next site of care   

• Follow-up to discharge ratios   

• Advanced care planning conversations   

A standardized scorecard promotes transparency, fosters accountability, trust, and a stronger culture of collaboration, all of which ultimately lead to better patient care.

Financial metrics: Revenue cycle and expense optimization   

When people think about revenue cycle optimization, the focus often falls on billing, collections, payer contracting, or patient copays. But true revenue optimization goes deeper—it’s about understanding the full journey of revenue generation and identifying where breakdowns occur. Across inpatient acute care episodes, there are six common areas where gaps typically emerge, each requiring a tailored solution:   

• ED admission   

• Status   

• Level of care   

• Transfer to floor   

• Two-minute benchmark   

• Discharge   

Expense optimization is a critical pillar of hospital financial health. In 2024, labor accounted for about 56% of total hospital expenses—nearly a trillion dollars nationwide—with a significant portion tied to inpatient provider groups. Partnering with the right physician group that delivers consistent quality while maintaining sustainable costs is essential. For instance, our four-year data in hospital medicine show that strong partnership models kept practice expenses stable despite inflation, aligning revenue growth with effective expense management to support long-term financial stability.  

Cultural metrics: Breaking barriers   

Arguably, the most important metrics to pay attention to are cultural metrics, which are a window into the internal dynamics of how our teams perform. They show whether teams are aligned and truly achieving excellence in the acute care patient experience.   

When performance breaks down, leaders must look closely to understand whether the root cause lies in design, behavior, or leadership. Are workflows and infrastructure built to foster excellence or create friction? Are teams open to improvement, or do they cling to “how we’ve always done it”? Are leaders proactive problem solvers or merely reactive observers? Each of these factors can either propel a culture of excellence or become a barrier to progress.  

Sometimes, the best solution is a good partner  

After examining the four metric dimensions that drive throughput—operational, clinical, financial, and cultural—it’s clear that even high-performing hospitals can hit a plateau. That’s when the right partner can make all the difference. An experienced partner should have a proven track record in reducing ED boarding, length of stay, discharge delays, and readmissions, along with robust data and analytics capabilities such as real-time dashboards, predictive insights, and hospital benchmarking.   

For hundreds of hospitals nationwide, Sound is that partner.

Want to learn more about our programs and metrics?