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Radiology benchmarking data a hot commodity.

Here's some help on where to look. When a Healthcare Benchmarks reader called our offices to ask if we know of any resources for radiology benchmarks, there was little thought that there might be a story in the request. But the reader was having trouble locating any data, and a cursory search of some major organizations and consulting groups turned up little information. But HB has located some resources for those looking for data, which we share this month.

Benchmarking↗

Benchmarking using simulated clinical scenarios: a feasibility project.

'Benchmarking' clinical practice and integrating such data with national guidelines offers a way of establishing standards for use in clinical governance. We report on a feasibility project for benchmarking clinical practice in one topic area (otitis media) using simulated clinical scenarios. Consistency and variations in clinical management were identified for different scenarios. Participants perceived the process likely to reflect actual practice and effect change in clinical management.

Acute Disease↗

Benchmarking your practice.

A medical practice is a business and as such is governed by the principles of good business management; these include planning, budgeting, and supervision. A benchmark comparison of a practice is the first step in identifying the factors that determine the financial performance of the practice. However, it is only a first step. Performance is also measured against expectations. A benchmark comparison against market data is not the only tool to use in managing a business successfully. Creating a financial budget together with performance standards is essential to developing and maintaining a healthy practice.

Benchmarking↗

Benchmarking: measuring the outcomes of evidence-based practice.

Measurement of the outcomes associated with implementation of evidence-based practice changes is becoming increasingly emphasized by multiple health care disciplines. A final step to the process of implementing and sustaining evidence-supported practice changes is that of outcomes evaluation and monitoring. The comparison of outcomes to internal and external measures is known as benchmarking. This article discusses evidence-based practice, provides an overview of outcomes evaluation, and describes the process of benchmarking to improve practice. A case study is used to illustrate this concept.

Benchmarking↗

Procedural restraint in children's nursing: using clinical benchmarks.

This paper will explore the use of child restraint during common clinical procedures such as venepuncture, cannulation and lumbar puncture. A lack of research, guidelines and protocols on restraining children led a group of student nurses to develop a clinical practice benchmark on procedural restraint for the North West Clinical Practice Benchmarking Group.

Benchmarking↗

Performance benchmarking. Part 2: Trends in home health care & what's in store for the future.

The need to change will catch up with an organization whether it overtly incorporates a change and evolution program or, less desirably, has to inefficiently react to and recover from change forced from the outside. The latter approach can be devastating in terms of staff morale, patient well-being, cost and revenues, staff retention, and organizational pride. It is far wiser to embrace, learn about, and efficiently incorporate the new practices and approaches in home health care that will result from progressively more emphasis on benchmarking, understanding and using the valuable benchmark information internally, and by virtue of understanding and using such information, contribute constructively to the evolution of home health care both externally and internally.

Benchmarking↗

Operational benchmarks. What CEOs want (need) to know.

Fazzi Associates began recruiting agencies to participate in a one-year study and later, for those interested, in a national benchmark service. What happened was nothing short of amazing. The response clearly showed how hungry home care leaders were for objective, valid comparative benchmark information on key performance indicators on all aspects of an agency's operation. And for the first time in the history of home care, agency CEOs could get clear answers to that one incredibly BIG question: "How are we doing?"

Administrative Personnel↗

Benchmarking and beyond. Information trends in home care.

With today's benchmarking concepts and tools, agencies have the unprecedented opportunity to use information as a strategic advantage. Because agencies are demanding more and better information, benchmark functionality has grown increasingly sophisticated. Agencies now require a new type of analysis, focused on high-level executive summaries while reducing the current "data overload."

Benchmarking↗

Using the STS and multinational cardiac surgical databases to establish risk-adjusted benchmarks for clinical outcomes.

One of the purposes of collecting data on cardiac surgical procedures, at a national level is to enable individual surgeons to improve quality and benchmark their own practice by making more accurate prospective prediction of outcome of each individual patient by using risk stratification based on previous local and national experiences. The past decade has seen a dramatic increase in the development of national cardiac surgical initiatives in many countries around the world. The size and extent of these databases has successfully allowed their use for patient risk stratification and preoperative risk modeling in four main aspects: patient selection and informed consent, coherent analysis of the determinants of patient outcomes, rationalizing unit management, and negotiations with external agencies. Approximately 610 cardiac surgical units presently contribute their patient data, containing pre-operative risk factors, to centralized national registries. There are currently nine different datasets used throughout the world to collect patient information. To harmonize the considerable diversity among these source materials, an International Dataset has been developed by a collaborative process among more than 50 cardiac surgeons around the world. Constructed around the Society of Thoracic Surgeons (STS) data format, the International Dataset brings in key elements from all the other datasets, allowing the sharing of data and cross-analysis, thus greatly expanding the pool of patients, and national sources, from which risk-stratifed outcomes can now be analyzed and unified. Unlike the STS dataset, the International Dataset incorporates EuroSCORE, a simple-to-use, validated patient risk stratification system, which has been rapidly adopted by large numbers of centers around the world for patient risk stratification, outcomes assessment, and improving patient informed consent. There are several benefits to collecting and centralizing national and international data: (1) understanding and defining basic demographics of patients undergoing cardiac surgery; (2) patient risk stratification and risk prediction at both a national and center-by-center level; (3) unit benchmarking, and development of effective nationally oriented and center-oriented quality improvement programs; (4) understanding and rationalizing resource utilization; and (5) use of data to leverage governments and other healthcare providers to affect policy. Cardiac surgical registries will soon attempt to track patients for longer follow-up periods after discharge in order to identify surgery-related deaths for more extended periods of time following surgery, thereby improving the monitoring and prediction of patient outcomes.

Benchmarking↗

Using benchmarking to manage your laboratory.

How does your cost per test compare with the competition? Does your productivity measure up? Benchmarking data provide the answers, but you may not realize just how far the information can go. In times of budget cuts, comparing your laboratory operations with the best performers can be crucial. The Virginia Commonwealth University Health System (VCUHS) Pathology Department in Richmond, Virginia, demonstrated that benchmarking is more than a paper exercise. It literally saved the laboratory. The keys were clarification, consistency, and communication.

Benchmarking↗

New benchmarks and design criteria for laboratory consolidations.

Benchmarks and design criteria previously used for planning consolidated laboratories such as bed size, staffing, and test volumes no longer apply. To achieve greater operational efficiencies, consolidated laboratories should be designed with open, flexible, and adaptable space using work flow/workstations, instrumentation requirements, and the degree of automation as the key design criteria. The primary objective of most consolidations is the reduction of staff with a substantial increase in workload. A critical factor when planning a consolidated laboratory is the ability of the space to accommodate the increase in testing and procedures to serve multiple facilities and growing outreach programs with fewer FTEs. Designing the laboratory starts with a thorough evaluation of work flow, testing procedures, desired adjacencies, and relationships within the laboratory. An area analysis should be developed describing in detail projected space requirements. Consideration should be given for the incorporation of automation/robotics and new, more efficient, and comprehensive instrumentation. Safety, noise, vibration control, lighting, and engineering support systems are all critical issues that also must be effectively addressed and incorporated into the design. Specific issues that will be discussed at this program include projected space requirements; review and development of existing and projected workstations; equipment requirements; lighting options; workload and procedures review; staffing procedures; flexibility/adaptability; relationships and adjacencies; flow diagrams; plan development; cost implications, on-site versus off-site facilities; and new construction versus renovation construction cost comparisons. Using specific examples from consolidated laboratory projects, we have designed a case study presentation by the laboratory director from a recently completed laboratory consolidation project serving a multihospital system. We will discuss the new design criteria and benchmarks that must be established to create a functional, operationally efficient, and profitable laboratory consolidation.

Automation↗

Benchmarking for prevention: the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance (NNIS) system experience.

Healthcare-associated infections are a major cause of morbidity and mortality at hospitals in the United States. Surveillance of these infections identifies secular trends and provides data upon which prevention interventions can be based in order to improve patient safety. National surveillance of healthcare-associated infections was initiated in the United States in 1970. Since that time, the Centers for Disease Control and Prevention's (CDC) National Nosocomial Infections Surveillance (NNIS) system has provided standardized methods for collecting and comparing healthcare-associated infection rates and the national benchmark infection rate data for inter- and intra-hospital comparisons. The surveillance methods used and results of the implementation of these methods are reviewed. The number of hospitals participating in the CDC's national surveillance of healthcare-associated infections has grown from approximately ten to 20 hospitals in 1970 to over 300 hospitals in 2002. Over the years, NNIS system participants have used standardized definitions, standardized surveillance component protocols, risk stratification for calculation of infection rates and provided national benchmark infection rates for inter- and intra-hospital comparisons. These methods have resulted in a significant reduction in bloodstream infections, urinary tract infections and pneumonia in intensive care unit (ICU) patients and surgical site infections in surgical patients. The NNIS data show that national surveillance of healthcare-associated infections combined with an intervention prevention program can reduce infection rates, reduce morbidity and mortality and improve patient safety. Establishment of such healthcare-associated infection surveillance and prevention systems in countries throughout the world should be a priority.

Benchmarking↗

Security-related benchmarking activities by North American hospitals.

The results of a CHPA-Fellowship research project conducted for the International Healthcare Security and Safety Foundation. The study measures the frequency of current benchmarking activity by hospitals in the U.S. and Canada, as well as other findings about benchmarking in the health arena.

Benchmarking↗