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PubMed1999

Select timely data and local benchmarks to profile MDs.

DATA BENCHMARKS: Seeking an effective way to let their physicians know their costs were too high and LOS too long, managers at two New York health care organizations began profiling the physicians by using data the physicians themselves deemed most appropriate. Find out what data they selected. And review samples of the reports they prepare for their physicians. It's all part of a new book from the publisher of CRR.

Arthroplasty, Replacement, Knee↗
PubMedDate not supplied

Tailored, not benchmarked. A fresh look at corporate planning.

In today's competitive markets, every company has an action plan. Yet for most managers, the processes used to create these plans don't work. The root of the problem, suggests Campbell, may be that too many companies benchmark their processes and by doing so, prevent managers from focusing on what is unique to their situation. Good planning processes, the author argues, are not generic processes but ones in which both analytic techniques and organizational processes are carefully tailored to the needs of individual businesses and to the skills of corporate managers. The author cites examples of three companies that have successfully individualized their processes: Granada, Dow Chemical Company, and Emerson Electric. A mature electrical-products business such as Emerson, he says, has different planning needs than a fast-growing entertainment business like Granada or a highly cyclical chemicals business like Dow. Different chief executives may have different insights about how to go about adding value. Take the CEOs of Granada and Dow. Both set tough targets to stretch their businesses, but the way each CEO gets his managers to commit to his targets differs considerably. Bad planning can actively destroy value, the author says. It wastes people's time and money. It sends the wrong signals to managers. It can even lead managers to follow bad advice. That's why managers should go to the effort of reexamining and possibly changing their company's planning process.

Benchmarking↗
PubMed1999

Benchmarking process reaps reductions in Medicare A/R days.

Preventing bottlenecks in the cash flow process. When one of the nation's largest hospital alliances launched a program to develop benchmarks for accounts receivable processes, it discovered a wide disparity in practices among the participating health systems. Further analysis disclosed best practices that help improve the economic vitality of hospitals. Find out what those practices are.

Accounts Payable and Receivable↗
PubMed1999

The effect of benchmarking clinical practice with the clinical laboratory. An institutional case study.

The improvement of quality in clinical care can greatly benefit form continuous benchmarking with information based on laboratory data. To be most effective, the information is best provided in the form of real-time disease management decision support. Such an approach requires advances in the implementation of hospital information systems. This article describes ground-breaking work at LDS Hospital in Salt Lake City, Utah that provides examples of major well-documented impacts of the "intelligent laboratory report" on patient outcomes.

Anti-Bacterial Agents↗
PubMed1999

Benchmark data outlined on senior surgery utilization.

Data File: The Center for Health Care Statistics in Hyattsville, MD, has released benchmark data on surgery visits by seniors, reporting that seniors have 3.5 times as many surgery visits as younger patients. To manage your Medicare surgery utilization, find out what the top diagnoses and procedures are for those visits.

Aged↗
PubMedDate not supplied

National benchmarking as a support system for clinical governance.

Audit of the management of acute asthma in hospital has developed in tandem with guidelines produced and updated by the British Thoracic Society (BTS), on the principle that agreed guidelines combined with systematic review of practice by periodic audit are more likely to result in improvements in practice than guidelines alone. A short audit data set was distilled from previous experience with more elaborate tools and made available nationally to audit departments and through letters to consultant members of the BTS. Hospitals have been able to contribute since 1990. The data set reflects key items of the process of care: peak flow measured on admission and twice daily during the hospital stay; blood gases on admission; systemic corticosteroids as an inpatient; discharged with inhaled and oral corticosteroids; written self-management plans; follow-up arrangements. Data from 4,741 admissions over a seven year period are presented. The proportion of patients nationally receiving these items of asthma care is given. The median values for hospital performance improved significantly over the seven years, although there is potential for further improvement. If these data represent the national picture, they could form the basis upon which to set national standards for the care of patients with acute asthma in hospital. A further result of the developing audit has been the recognition of the value of external benchmarking in providing a context for the interpretation of local audit results. This audit system provides hospitals with a quick and easy method of obtaining an overview of local performance, with comparative national data for the same year. This has potential as a tool for clinical governance with much wider applicability, providing the data are handled carefully, particularly as the variability between hospitals diminishes over time.

Asthma↗
PubMed2000

Benchmarking the vital risk of waiting for coronary artery bypass surgery in Ontario.

BACKGROUND: Deaths among patients awaiting coronary artery bypass grafting (CABG) are a source of private grief and public concern in Canada. However, some deaths are expected over time among patients with coronary artery disease. Methods of benchmarking the burden of delayed care may be useful in understanding and managing waiting lists for CABG and other health services. The authors therefore determined the vital risk among people waiting for CABG in Ontario and compared it with the risk in the general population and among people living with coronary artery disease. METHODS: Patients registered to undergo CABG in Ontario between 1991 and 1995 were followed to ascertain numbers and dates of preoperative deaths or completed operations. Linking hospital discharge abstract data to vital statistics for 1991 to 1994, the authors defined a cohort of people who had survived 6 months after an acute myocardial infarction (AMI) and followed them for an additional 6 months to determine numbers and dates of deaths. They matched patients by age and sex and then calculated the standardized mortality ratio for each cohort (i.e., the ratio of observed deaths to those expected based on age- and sex-specific daily probabilities of death for the provincial population). RESULTS: Among 21,220 patients awaiting CABG, there were 82 preoperative deaths over a median follow-up of 18 days; the standardized mortality ratio was 2.92 (95% confidence limit [CL] 2.29-3.55). Among 21,220 matched 6-month survivors of an AMI, there were 663 deaths over a median follow up of 185 days; the standardized mortality ratio was 3.84 (95% CI 3.54-4.14). INTERPRETATION: Patients awaiting CABG in Ontario are at a much greater risk of death than the general population. However, when compared with thousands of other patients living with coronary artery disease, they are at similar or decreased vital risk.

Aged↗
PubMed1999

An audit on access to coronary artery surgery within a health district using New Zealand priority criteria as a benchmark.

A professional advisory group in New Zealand, consisting of cardiologists, cardiac surgeons and general practitioners have recommended priority criteria for access to Coronary-Artery Bypass Graft (CABG). They used published outcome studies in developing the criteria, and numerical scores were assigned to both biological and social dimensions of ischaemic heart disease. The New Zealand criteria were used to investigate access to services for patients in the UK in Sunderland, Tyne and Wear. Case notes of 229 Sunderland residents who underwent coronary angiography in the 1995 96 financial year were reviewed. The clinical threshold for access to CABG was much higher in Sunderland than in New Zealand. After controlling for the severity of disease, there was no evidence of inequity of access based on age, gender, smoking status or the deprivation indices of the patients' ward of residence. The correlation between the New Zealand Priority Criteria scores and the waiting time for coronary angiography, CABG and Percutaneous Transluminal Coronary Angioplasty (PTCA) was present, but weak (r = -0.22, -0.1 and -0.54 respectively). The New Zealand consensus criteria proved a useful benchmark both to assess access for patients with ischaemic heart disease to coronary artery surgery in a local Health District and to prioritise patients on the waiting list for coronary artery surgery. They allowed a realistic assessment of access according to age, gender, smoking status and deprivation by taking disease severity into account.

Benchmarking↗
PubMed2000

Benchmarking facilitates process improvement in the emergency department.

The emergency department (ED) is an important source of revenue for hospitals. Patient satisfaction is necessary to any effort to optimize revenues. If patients fail to move efficiently through the ED, their perception of the experience might be negative. To facilitate process improvement in the ED, hospitals need to identify critical success factors and appropriate measures, collect data on their patient-flow process, compare those data with industry benchmarks, and then determine areas for improvement. With this information, an action plan can be designed to improve patient-throughput time and patient satisfaction without lowering the quality of care delivered.

Benchmarking↗
PubMed2001

2001 benchmarking guide.

Our fifth annual guide to benchmarking under managed care presents data that is a study in market dynamics and adaptation. New this year are financial indicators on HMOs exiting the market and those remaining. Hospital financial ratios and details on department performance are included. The physician group practice numbers show why physicians are scrutinizing capitated payments. Overall, hospitals in markets with high managed care penetration are more successful in managing labor costs and show productivity gains in imaging services, physical therapy and materials management.

Benchmarking↗
PubMed2001

Trauma program bolsters case for better equipment with benchmarking study.

Gregory Jurkovich, MD, FACS, head of trauma at Harborview Medical Center in Seattle, contended that patients with severe head injuries did better when they had intercranial pressure monitors. But it is an expensive proposition that some might question. So it was nice to get support from national benchmarking data that the best trauma programs did just what his physicians did at Harborview.

Abdominal Injuries↗
PubMed2001

Use data benchmarks to boost labor productivity.

The key to effective and long-lasting improvement in labor productivity is to equip middle managers with the right tools, says a former hospital administrator now serving as a consultant. One strategy is to look hard at typically ignored labor benchmarks.

Benchmarking↗
PubMed2001

Future of benchmarking: more data, more sharing, and better patient care.

Automated systems that provide whatever regulatory information is needed when it is needed; sharing of data to improve quality; data mined for specific groups of patients: Those are just a few of the trends predicted by health care experts asked to comment on the future of benchmarking and data strategies. Such improvements are needed; many hospitals continually run into problems when it comes to finding the right data sets for targeted patient groups.

Benchmarking↗
PubMed2001

New data combat lack of critical care benchmarks.

A new study, the ICU Benchmarks for Success report, published in February by Baltimore-based Solucient (formerly HCIA-Sachs) identifies several significant opportunities for hospitals to improve their performance, if they adopt the practices of top performers.

Benchmarking↗
PubMed2001

Successful database benchmarking: what do we need?

As the technology of on-line healthcare information advances, hospitals and data vendors are faced with a variety of challenges. What are the accepted standard fields? What kind of DSS system should we use? Which system will give us the information we need? Does the server have enough space to handle increased business? Healthcare organizations are now looking at comparative information through the Internet instead of buying data and loading it onto their own servers. They are asking: Are servers necessary now? Is the software user-friendly? How current and accurate is the information being offered? How secure is the Web site it is on? Data vendors are asking: Is our server large enough to handle the volume of data we now have and as the company grows? How do we make sure the data are accurate? How do we keep the data secure? This article educates and informs healthcare facilities about the factors that should be considered when comparing their own data with those of other hospitals in an on-line benchmarking database warehouse.

Benchmarking↗