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July 13, 2012

Hospital Benchmarking

With a growing number of hospitals choosing more comprehensive benchmarking strategies, there is a need to reevaluate what your organization is benchmarking and how it is used to improve your facility's overall performance.  Healthcare facilities are also turning toward inclusive benchmarking practices due to the ties to accreditation status and reimbursement levels established by payors and accrediting groups like the Joint Commission.

Without established benchmarks or productivity measures, it is difficult for hospitals to control and regulate staffing levels, which is critical to a financially sound institution.

In this offering of Off the Shelf we present you with the myriad of benchmarking types to ensure that you are consolidating and utilizing all the measures available to your facility.  Facilities that organize these practices are able to measure their facility's cost-effectiveness, efficiency, and quality of patient care

Internal & External Benchmarking

On the whole, benchmarking in healthcare organizations collaboratively determining an appropriate goal or objective, defining the relevant performance indicators, collecting the related data, and continually comparing and contrasting that data to determine where the hospital stands in relation to others.

  • Internal benchmarking assesses related key work processes within the same organization and makes comparisons accordingly. It identifies best practices within a hospital, compares those best practices with others throughout the facility, and evaluates existing practices over time. But relying on your facility's internal benchmarking efforts will not necessarily characterize best performance techniques elsewhere, so external benchmarking should also be utilized.
  • External or competitive benchmarking compares your hospital's practices, including quality and safety, with those considered leaders in the healthcare industry. By going outside of your organization, you can look to the industry leaders and judge your performance based on the achievements of other organizations and pinpoint successful improvements that were shown to be effective.
Structure, Process, & Outcome Measures

With a multitude of quality measurements being used for benchmarking purposes, most can be classified into one of these categories: structure, process, and outcome.

Structure measures
are how hospitals identify and report on the administrative and organizational resources linked to the delivery of patient care, as well as how IT systems are being utilized in clinical care. They examine the environment where the healthcare facility is offering its services by capturing and gauging the availability, ease of access and value of hospital resources, including health insurance, bed capacity, staff credentials and qualifications, and operational capabilities. For instance, tracking the amount of nursing hours per patient day and the number of delayed surgical cases would be examples of structural measures.

Process measures
evaluate the method of delivering healthcare services. They emphasize the capability of the hospital to screen, diagnose, and manage a patient's illness throughout the course of their treatment. Process measures also focus on the accuracy and timeliness of the diagnosis as well as any mishaps or difficulties during treatment. Examples include procedures, surgeries, tests and other actions provided for the patient.

Process measures are routinely compiled and reported to other healthcare organizations such as CMS, payers and other third-party quality groups. From the results of the process quality measures, these organizations grade the hospitals based on the data gathered, which is then used by patients and end-users to compare the quality of facilities, staff, physicians, etc. when deciding where to go to receive a treatment.

Outcome measures
track the final results of patient care, including mortality, patient satisfaction, and improved health status. Shaped by behavioral and environmental factors, these measures record the end state of a patient after having gone through the patient care processes and determine the result that structure and process measures have on patients. Hospitals regularly perform outcome measures to make decisions regarding internal quality improvement. CMS regularly publishes this information and uses it to develop reports for consumers that compare and contrast healthcare of hospitals in their area, including the rate of post-operative infections in surgical patients and morbidity and mortality in patient populations.

Moving Forward

Once benchmarking is in place, make sure your quality improvement efforts lead to positive changes. In the end, benchmarking should pave the way for high performance and successful operations so monitor the results closely. The key is to continually improve hospital practices which in turn improves overall performance.

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