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Healthcare Benchmarks Hold Key to Settingand Meeting Standards By Nikolas Matthes, MD, PhD, MPH Vice President, Research & Development Quality Indicator Project®  Measuring Up Over the last decade, hospitals and healthcare providers have increasingly faced new demands for better, more efficient performance. This is a trend that is only accelerating as payors, regulators and even patients demand to know how one provider stacks up against another in terms of performance and meeting certain standards. The most effective way to meet these challenges is through the use of the standards and tools that healthcare benchmarks provide us. Benchmarking Performance Healthcare benchmarks enable you to see and understand how other organizations and individuals are achieving success. If I'm a medium-size hospital or healthcare provider, I can learn what other similar organizations are doing to deal with similar clinical issues. Is it just me who is not doing it well, or is this a common problem? Prioritizing Improvement. Healthcare benchmarks enable you to prioritize improvement opportunities. You know that on a range of measures you compare well with other similar providers, but on one measure, the outcomes are much worse. This knowledge can guide you to areas where more resources and attention are needed. Setting Intermediate Goals. With priorities set, your organization can create intermediate improvement goals. While the ultimate objective for a particular procedure might be 100%, achieving it can realistically only occur in stages. That requires setting milestones that staff and departments can reach, and in the process, creating success stories that keep everyone motivated. For now, you might say that you're happy to be doing as well as the average hospital. Then you can set a goal of moving up to the 90th percentile within 12 months. At each point, you know where you are and how you compare to others. You also know that you can reach these new goals because others have already done so. Accessing Best Practices. Healthcare benchmarks also teach us how to improve. All standards represent certain clinical practices. As we explore the successful actions of others, we find those that we can emulate in order to achieve the same success. Thus, benchmarking becomes more than just data and comparisons. It provides access to the best practices that lead to success. Making Comparisons Apples to Apples. As healthcare benchmarks have become more sophisticated, and the number of participating organizations has increased, it's easier to compare similar providers. Rural community hospitals can compare themselves to other small organizations, while academic medical centers can match their metrics to similar facilities. Apples to Oranges. Some comparisons are not so easy to make. Take, for example, the idea that facilities that perform large numbers of a specific procedure produce better results than smaller organizations that perform fewer. While evidence supports this idea, in some cases there are smaller centers of excellence that are able to produce high-quality results despite their smaller size. No Comparison. For standards that are evidence-based, there is only one right way of doing things no matter the size or location. Research has given us best practices such as administering beta blockers to heart attack patients or an ace inhibitor to those with heart failure. Certain standards of performance must always be met no matter the size or nature of the hospital. Looking to Others. Other areas of healthcare are not so clear cut, and few best practices are backed by clinical trials to show you how to proceed. It becomes more important to compare your organization to others that are similar to get an understanding of how well you are doing and how you can improve. Picking the right comparison group will yield the best results. Looking Within. Improving performance is also about eliminating variations in performance. Unstable processes can yield great results one month and lesser outcomes the next. And, here, benchmarking becomes less about comparing yourself to those outside your institution and more about looking within over time to achieve the highest performance possible. Better defining the path to quality improvement is what healthcare benchmarks are all about. In some clinical processes, we have access to clear, evidence-based procedures — gold standards that define how we should proceed. However, knowing the standards doesn't mean that you can move easily from a low level of performance to a high one. It is the data gained from healthcare benchmarks that enables you to identify the steps to take toward achieving your goals. Dr. Nikolas Matthes is vice president, Research & Development for the Quality Indicator Project® at the Maryland Hospital Association. Dr Matthes has more than 12 years of experience in developing clinical performance measures and software applications for data analysis, analyzing performance data including statistical process control, and research. He has served on a technical advisory panel for the National Quality Forum and is a principal investigator for the Agency for Healthcare Research and Quality. Dr. Matthes currently holds an adjunct appointment as assistant professor in Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. He holds an MD degree from the Freie Universität Berlin, a PhD from Heidelberg University, a Master of Public Health from Johns Hopkins, and a Master of Science in Economic and Social History from Oxford University.
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