Need proof that benchmarking works?
Here are stories to convince you
For skeptics who think they are different from other health care organizations, for those who think that benchmarking is a curse designed to waste precious time and resources, and those who think it all comes to nothing, here are some stories to help convince them otherwise:
- Think you’re too different?
One health care system had a big problem with workers’ compensation claims, recalls Robert Gift, president of Systems Manage-ment Associates, a health care consulting firm based in Omaha, NE. A group of 12 facilities, large and small, covering the whole country, worked together and identified more than 40 procedures that if amended would impact workers’ comp claims positively. The facilities ranged in size from 50 to 600 beds, disproving the theory that comparing your facility with an organization that isn’t the same size as yours or in the same location can’t possibly be relevant.
- Think small can’t mean good?
Gift recalls one group of small hospitals that brought staff together and discussed lab efficiency. Together the group came up with 53 ideas to improve efficiency and cost-effectiveness. While not all of the locations implemented all of the ideas, the collaboration helped all participants. "Ironically, some of the more cost-efficient labs turned out to be from the smallest facilities," he says.
- Think it takes too many resources?
One home care agency was facing a huge deficit as a result of the many payment changes facing the industry, says Gift. The agency was very small, with an average daily census of just 20 patients. By looking at information that already was published, using the Internet, and using the telephone rather than making site visits, the agency was able to make some operational changes in 10 weeks using only four people to develop and implement the project. The annual savings were $163,000.
- Think it doesn’t have a positive impact on patients?
At Punxsutawney (PA) Area Hospital, a three-year project led to a change in protocols for patients coming into the emergency department with chest pains, says Ben Hughes, MS, director of planning, marketing, and development at the 69-bed facility. The project eventually resulted in a decrease in the number of patients who had to be flown to a larger facility for more intensive care.
|Focus: Timeliness of communication of essential patient data among the care team|
|Numerator: Inpatient medical records, which do not reflect a dictated history and physical within 24 hours of admission|
|Denominator: Total monthly admissions|
|Focus: Pediatric assessment parameters|
|Numerator: Pediatric (< 1 year) head and chest circumference; growth and development assessment (< 16 years); initiation of plan of care (< 16 years)|
|Denominator: All pediatric admissions|
|Focus: Timeliness of communication of pertinent operative findings among the care team|
|Numerator: Inpatient and short procedure records that do not reflect a dictated operative report within the same operative day|
|Denominator: Total monthly operative procedures|
|Focus: Timeliness of record closure|
|Numerator: Total medical records delinquent at 30 days|
|Denominator: Total number of discharges for the month|
|Focus: Prenatal patient evaluation, education, and treatment selection|
|Numerator: Patients treated by cesareans|
|Denominator: All deliveries|
|Focus: Patient treatment effectiveness|
|Numerator: Inpatient mortalities|
|Denominator: Total number of discharges|
|Focus: Safety of medication administration|
|Numerator: Significant medication errors|
|Continuum of care|
|Focus: Home care nursing productivity|
|Numerator: Total skilled nursing visits|
|Denominator: Total skilled nursing hours|
|Focus: Monitoring patient compliance|
|Numerator: Patients completing cardiac rehabilitation|
|Denominator: Total patients referred|
|Patient rights and responsibilities|
|Focus: Restraint reduction initiative|
|Numerator: Episodes of restraint|
|Denominator: 1,000 patient days|
|Surveillance prevention and control of infection|
|Focus: Targeted reduction in hospital-acquired infections|
|Numerator: Surgical site infections|
|Denominator: Total admissions|
|Human resource management|
|Focus: Acuity/staffing variance|
|Numerator: Monthly average full-time equivalent (FTE) required by acuity|
|Denominator: Monthly average FTE actual|
|Focus: Employment stability|
|Numerator: Employment terminations|
|Denominator: FTE employment|
|Focus: Ability to pay short-term liabilities|
|Numerator: Current assets|
|Denominator: Current liabilities|
|Focus: Time required to collect patient accounts|
|Numerator: Ending net accounts receivable|
|Denominator: Average daily net revenue|
|Focus: Profitability from health care operations|
|Numerator: Operating income (loss)|
|Denominator: Net patient revenue|