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.

Punxsutawney Benchmarks
Patient assessment
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
Reported: Monthly
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
Reported: Quarterly
Information management
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
Reported: Monthly
Focus: Timeliness of record closure
Numerator: Total medical records delinquent at 30 days
Denominator: Total number of discharges for the month
Reported: Monthly
Patient care
Focus: Prenatal patient evaluation, education, and treatment selection
Numerator: Patients treated by cesareans
Denominator: All deliveries
Reported: Monthly
Focus: Patient treatment effectiveness
Numerator: Inpatient mortalities
Denominator: Total number of discharges
Reported: Monthly
Focus: Safety of medication administration
Numerator: Significant medication errors
Denominator: N/A
Reported: Monthly
Continuum of care
Focus: Home care nursing productivity
Numerator: Total skilled nursing visits
Denominator: Total skilled nursing hours
Reported: Monthly
Focus: Monitoring patient compliance
Numerator: Patients completing cardiac rehabilitation
Denominator: Total patients referred
Reported: Monthly
Patient rights and responsibilities
Focus: Restraint reduction initiative
Numerator: Episodes of restraint
Denominator: 1,000 patient days
Reported: Quarterly
Surveillance prevention and control of infection
Focus: Targeted reduction in hospital-acquired infections
Numerator: Surgical site infections
Denominator: Total admissions
Reported: Monthly
Human resource management
Focus: Acuity/staffing variance
Numerator: Monthly average full-time equivalent (FTE) required by acuity
Denominator: Monthly average FTE actual
Reported: Monthly
Focus: Employment stability
Numerator: Employment terminations
Denominator: FTE employment
Reported: Monthly
Financial management
Focus: Ability to pay short-term liabilities
Numerator: Current assets
Denominator: Current liabilities
Reported: Monthly
Focus: Time required to collect patient accounts
Numerator: Ending net accounts receivable
Denominator: Average daily net revenue
Reported: Monthly
Focus: Profitability from health care operations
Numerator: Operating income (loss)
Denominator: Net patient revenue
Reported: Monthly