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Healthcare Benchmarks Enable Sustainable Excellence for Healthcare OrganizationsBy Connie Moser Vice President, Performance Management Solution Line McKesson Provider Technologies Beyond Measurement There's an old saying in business that "what gets measured, gets done." In healthcare, however, measuring is just one part of an integrated process that enables organizations to track and understand data. Access to meaningful data can enable real process change that improves efficiency and patient safety. The true value of healthcare benchmarks lies in the ability of organizations to drill down to the root cause level of operational efficiency. Knowing why and how something happened, coupled with the ability to set genuine standards for performance, becomes the key to real and lasting change. Healthcare benchmarks provide the greatest validity when an organization can make a true peer-to-peer comparison. Using benchmarking, hospitals can employ performance indicators for operational throughput, efficiency, and quality. Categories for comparison are wide ranging and include start time accuracy, patient in room to incision time, total case time, turnover time, utilization by hour of day, add-on and cancellation rate, return to surgery within 24 hours, and others. Healthcare benchmarks enable organizations to self-select their own peers and set up meaningful comparisons by defining region, bed size, the number of ORs, demographics such as urban or rural, and other attributes. Once the organization defines its peer groups, it can select the statistical parameter to compare itself against, such as percentile or best practice. A valid benchmarking tool enables users not just to set standards, but to quickly recognize trending and deviations from those standards. Once unfavorable developments are recognized, stakeholders can then identify the specific causes — whether processes or people. Once causes are identified, the organization can undertake the actions needed to correct the deficiencies. An OR Benchmarks Collaborative Hospitals have long possessed considerable amounts of data within their systems. However, until now, they were unable to produce timely reports that were usable for instituting change. Surgical units might produce delay statistics, but they lacked the capacity to filter and reorganize data into an actionable format. They couldn't determine that it was Dr. A, the anesthesiologist, who continually generated late starts. You might suspect it, but you couldn't demonstrate it in a way that produced behavior change. The OR Benchmarks® Collaborative (ORBC), a partnership between McKesson and OR Manager, Inc, is a collaborative of more than 400 healthcare organizations. Members provide monthly trend data on 20 key performance indicators, use online dashboards to access their internal data by a variety of criteria, and make peer-to-peer benchmark comparisons. One major benefit is the ability to provide true statistical relevance between similar classes of facilities — from large academic medical centers to small community hospitals. The collaborative enables healthcare organizations to:  Capitalize on the data byproduct of clinical and financial workflow Identify and set performance goals Monitor internal processes and identify trending and variability Manage process changeAn organization can create a visual scorecard that signals its level of success for performance indicators — a green check, yellow caution sign, or red x to indicate an opportunity for improvement. For example, a green check might mean it is within 90% of its selected peer group's performance at the selected statistical parameter. That green check could be set to appear only if it is within 99% of that peer's performance. Organizations align their healthcare benchmarks strategy with culture and goals for maximum efficiency. Statistically Valid To ensure that ORBC was indeed producing statistically valid comparisons, it engaged an outside firm that specializes in data management to validate the benchmarks. A team of biostatisticians deconstructed our model by taking both raw and analyzed data, and comparing it to statistical models for validity of assumptions and calculations. All healthcare benchmarks were thoroughly analyzed for validation against a statistical standard, and each passed with flying colors. With credible data, the process of reengineering becomes easier. A reality of organizational life is that people tend to resist change in the absence of compelling data. If I don't trust your information and how you obtained it, then I'm less likely to embrace a new process, which means more work without the certainty of better results. Validated benchmarking carries with it the assurance that an organization can now share one truth. Masses of data become manageable. Stakeholders can access root causes, identify opportunities for change, and then set standards that are comparable to other similar organizations. However, while healthcare benchmarking is clearly useful, its true value lies in the ability to create continuing and sustainable change within the healthcare organization. It is in these continuous improvements that real excellence will be found, and great healthcare organizations built. Connie Moser leads the Performance Management division within McKesson Provider Technologies and has more than 19 years experience in the healthcare industry. She served a three-year term as the public board member for the Competency and Credentialing Institute, a nonprofit organization focused on enhancing patient safety through surgical nurse certification, where she also held the roles of Secretary/Treasurer for two years. Additionally, Moser has presented on operational redesign to healthcare industry organizations, including HIMSS, HFMA and NAHAM.
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