Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Benchmarking”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2005

Environmental benchmarks vs. ecological benchmarks for assessment and monitoring in Canada: is there a difference?

Environmental benchmarks are widely used in Canadian environmental assessment as a standard against which to monitor air or water quality in response to human activities in the environment. Recent work in Canada has developed the concept of ecological benchmarks as a complement to environmental benchmarks. However, implementation of ecological benchmarks may be challenging. This paper presents an analogy between ecological benchmarks and the more commonly used environmental benchmarks, as an attempt to increase understanding and use of ecological benchmarks in resource management, assessment, and monitoring. Ecological benchmarks, and their corresponding indicators, will be challenging to identify and use. However, through the use of the principles of adaptive management, effective ecological indicators and benchmarks can be established. Although it is essential that ecological benchmarks are site-specific, the analogy and general principles outlined here are applicable to assessment and monitoring in any part of the world.

Canada↗
PubMed1995

The Benchmarking Effort for Networking Children's Hospitals (BENCHmark).

BACKGROUND: In 1992, 12 large children's hospitals established the Benchmarking Effort for Networking Children's Hospitals (BENCHmark). The goal was for the BENCHmark effort to supplement the hospitals' continuous quality improvement (CQI) programs and to speed adoption of best practices from peer institutions. For three years, the hospitals have been comparing data on cost, quality, and speed indicators. Also, "best practice" groups have met to share information on how processes can be improved. RESULTS: The BENCHmark hospitals have experienced significant process improvement in areas such as emergency department waiting time and admitting process time. EXAMPLE: The BENCHmark hospitals selected admitting as one of the first best practice groups to meet. Interdisciplinary staff from all BENCHmark hospitals met three times over the course of a year to define their indicator and share information on best practices. St Louis Children's Hospital, as a result, instituted a pre-arrival team and cross-trained staff, with the result being a reduction of admitting processing time from 58 minutes to 19 minutes. Same-day surgery patients now bypass the admitting department and go directly to the surgical floor. Patient and surgeon satisfaction has increased greatly. CONCLUSIONS: Hospitals that are planning to benchmark are encouraged to reach consensus on project goals and to focus on indicators that provide a clear business advantage. Physician involvement is key to improving performance and physicians will only be engaged if the hospitals against whom they are benchmarked are considered peers. Being willing to share initial data openly seems to be a key factor in determining successful integration of the BENCHmark process into hospital CQI efforts. The BENCHmark project has been so successful that a second group of 12 comparable pediatric institutions, known as the Network II, has been established.

Efficiency, Organizational↗
PubMed1999

Achievable benchmarks of care: the ABCs of benchmarking.

Benchmarking is generally considered to be an important tool for quality improvement. Traditional approaches to benchmarking have relied on subjective identification of 'leaders in the field'. We derive an objective, reproducible and attainable Achievable Benchmark of Care (ABC) by measuring and analysing performance on process-of-care indicators. Three characteristics of the ABC that we deem essential are: (1) benchmarks represent a measurable level of excellence; (2) benchmarks are demonstrably attainable; (3) benchmarks are derived from data in an objective, reproducible and predetermined fashion. From these characteristics it follows that (4) providers with high performance are selected to define a level of excellence in a predetermined fashion, but (5) providers with high performance on small numbers of cases do not influence unduly benchmark levels. We use the 'pared mean' to operationalize the ABC. Roughly, the pared mean summarizes the performance of top-ranked providers whereby at least 10% of the patient pool across all providers is included. Bayesian estimators for adjustment of performance of providers with small sample sizes are used to rank providers. Randomized controlled trials to assess the independent effect of the ABC in quality improvement projects are under way. We have developed a methodology objectively and reproducibly to derive a level of excellent, attainable performance, based on measured performance by a group of providers. The ABC can be applied to groups of providers in communities, to institutions and departments within them, or to individual practitioners.

Bayes Theorem↗
PubMedDate not supplied

Benchmarking, benchmarks, or best practices? Applying quality improvement principles to decrease surgical turnaround time.

BACKGROUND: The processes of benchmarking, benchmark data comparative analysis, and study of best practices are distinctly different. The study of best practices is explained with an example based on the Arthur Andersen & Co. 1992 "Study of Best Practices in Ambulatory Surgery". METHODS: The results of a national best practices study in ambulatory surgery were used to provide our quality improvement team with the goal of improving the turnaround time between surgical cases. The team used a seven-step quality improvement problem-solving process to improve the surgical turnaround time. RESULTS: The national benchmark for turnaround times between surgical cases in 1992 was 13.5 minutes. The initial turnaround time at St. Joseph's Medical Center was 19.9 minutes. After the team implemented solutions, the time was reduced to an average of 16.3 minutes, an 18% improvement. Cost-benefit analysis showed a potential enhanced revenue of approximately $300,000, or a potential savings of $10,119. CONCLUSIONS: Applying quality improvement principles to benchmarking, benchmarks, or best practices can improve process performance. Understanding which form of benchmarking the institution wishes to embark on will help focus a team and use appropriate resources. Communicating with professional organizations that have experience in benchmarking will save time and money and help achieve the desired results.

Ambulatory Surgical Procedures↗
PubMed1995

Benchmark Dose Workshop: criteria for use of a benchmark dose to estimate a reference dose.

The purpose of the Benchmark Dose Workshop was to assess the feasibility and implications of replacing the no observed adverse effect level (NOAEL) with a benchmark dose (BMD) when deriving reference doses and concentrations (RfDs and RfCs). The workshop participants supported the use of the BMD method to remove many of the limitations inherent in using the NOAEL approach. Participants endorsed in general the use of a BMD for all quantal noncancer health effects and endorsed in particular the BMD for assessing developmental toxicity based on data presented at the workshop. The discussions of implementation recognized the need to demonstrate that changing from a NOAEL to a BMD gives the risk manager more certain information on which to base decisions. Most participants agreed that the current NOAEL-derived RfDs and RfCs are sufficiently protective and should only be changed as data become available for estimating a BMD. It was recognized that to achieve general acceptance of the BMD approach, it will have to be applied to a variety of endpoints.

Animals↗
PubMed2006

All inclusive benchmarking.

AIM: The aim of this article is to review published descriptions of benchmarking activity and synthesize benchmarking principles to encourage the acceptance and use of Essence of Care as a new benchmarking approach to continuous quality improvement, and to promote its acceptance as an integral and effective part of benchmarking activity in health services. BACKGROUND: The Essence of Care, was launched by the Department of Health in England in 2001 to provide a benchmarking tool kit to support continuous improvement in the quality of fundamental aspects of health care, for example, privacy and dignity, nutrition and hygiene. The tool kit is now being effectively used by some frontline staff. However, use is inconsistent, with the value of the tool kit, or the support clinical practice benchmarking requires to be effective, not always recognized or provided by National Health Service managers, who are absorbed with the use of quantitative benchmarking approaches and measurability of comparative performance data. REVIEW: This review of published benchmarking literature, was obtained through an ever-narrowing search strategy commencing from benchmarking within quality improvement literature through to benchmarking activity in health services and including access to not only published examples of benchmarking approaches and models used but the actual consideration of web-based benchmarking data. This supported identification of how benchmarking approaches have developed and been used, remaining true to the basic benchmarking principles of continuous improvement through comparison and sharing (Camp 1989). Descriptions of models and exemplars of quantitative and specifically performance benchmarking activity in industry abound (Camp 1998), with far fewer examples of more qualitative and process benchmarking approaches in use in the public services and then applied to the health service (Bullivant 1998). The literature is also in the main descriptive in its support of the effectiveness of benchmarking activity and although this does not seem to have restricted its popularity in quantitative activity, reticence about the value of the more qualitative approaches, for example Essence of Care, needs to be overcome in order to improve the quality of patient care and experiences. KEY ISSUES: The perceived immeasurability and subjectivity of Essence of Care and clinical practice benchmarks means that these benchmarking approaches are not always accepted or supported by health service organizations as valid benchmarking activity. CONCLUSIONS: In conclusion, Essence of Care benchmarking is a sophisticated clinical practice benchmarking approach which needs to be accepted as an integral part of health service benchmarking activity to support improvement in the quality of patient care and experiences.

Benchmarking↗
PubMed1994

Benchmarking applied to health care.

BACKGROUND: An operational definition of benchmarking as developed at Xerox is "finding and implementing best practices." Although benchmarking has widely spread throughout industry, it is only just beginning to find application in health care. TYPES OF BENCHMARKING: In internal benchmarking, similar internal functions serve as pilot sites for conducting benchmarking. Competitive benchmarking, the comparison of a work process with that of the best competitor, reveals the performance measure levels to be surpassed. Functional benchmarking compares a work function to that of the functional leader. Generic process benchmarking compares the organization's basic business processes. ADAPTING BENCHMARKING TO HEALTH CARE: Benchmarking can target business, support, and clinical functions. For clinical functions, there are many potential, ready-made networks of people with similar problems and interests. Benchmarking support functions is often difficult because these functions can provide the greatest competitive edge in the purely business sense. A GRASSROOTS BENCHMARKING EXAMPLE: The ten-step Xerox benchmarking model is illustrated with a fictional case study involving improvement in the work processes associated with outpatient and inpatient biopsies. CONCLUSION: The principles of benchmarking are simple, and the benchmarking process is not complicated. Benchmarking is a structured framework for pursuing worthwhile goals in an organized way.

Data Collection↗
PubMed1994

Collaborative benchmarking in health care.

BACKGROUND: A collaborative approach to traditional benchmarking involves the formation of a voluntary network of health care providers that cooperate in carrying out the benchmarking study. THE COLLABORATIVE APPROACH: Collaborative benchmarking involves three phases: Select the benchmarking topic. Decision makers at the sponsoring organization select the benchmarking topic. Establish the benchmarking collaborative. Potential participant organizations are identified and encouraged to join the collaborative. Once the collaborative is formed, project stakeholders are identified, a charter for the study is created, and the project steering committee is established. Conduct the study. A combination of internal and external benchmarking can be used, first conducting the project within the collaborative, then repeating the study either within the industry or across industries. Regardless of the benchmarking type selected, the process follows the Plan-Do-Study-Act cycle. An example of a health care system that is benchmarking the workers' compensation process is used to illustrate the three phases of collaborative benchmarking. A second example, which describes a benchmarking project focused on the admissions process, illustrates the external benchmarking phase. PREREQUISITES AND ACCELERATORS: Four prerequisites for effective benchmarking are leadership commitment, experience with continuous quality improvement, preparation of the organization, and identification of key processes. Organizational capacity for learning, knowledge of the customer and process variation, resource availability, and leadership understanding of benchmarking may each accelerate, or retard, the effective use of collaborative benchmarking.

Consumer Behavior↗
PubMed1998

Identifying achievable benchmarks of care: concepts and methodology.

Webster's Dictionary defines a benchmark as 'something that serves as a standard by which others can be measured'. Benchmarking pervades the health care quality improvement literature, and benchmarks are usually based on subjective assessment rather than on measurements derived from data. As such, benchmarks may fail to yield an achievable level of excellence that can be replicated under specific conditions. In this paper, we provide an overview of benchmarking in health care. We then describe the evolution of our data-driven method for identifying an Achievable Benchmark of Care (ABC) on the basis of process-of-care indicators. Here, our experience leads us to postulate the following premises for sound benchmarks: (i) benchmarks should represent a level of excellence; (ii) benchmarks should be demonstrably attainable; (iii) providers with high performance should be selected from among all providers in a predefined way using reliable data; (iv) all providers with high performance levels should contribute to the benchmark level; and (v) providers with high performance levels but small numbers of cases should not unduly influence the level of the benchmark. An example of an ABC applied to the cooperative cardiovascular project leads the reader through the computation of an ABC. Finally, we consider several refinements of the original ABC concept that are in progress, e.g. how to approach the special problems posed by very small denominators. The ABC methodology has been well accepted in multiple quality improvement projects. This approach lends objectivity and reliability to benchmarks that have been a widely used, but until now, arbitrarily defined tool.

Alabama↗
PubMed2003

The benchmark dose method--review of available models, and recommendations for application in health risk assessment.

The benchmark dose method has been proposed as an alternative to the no-observed-adverse-effect level (NOAEL) approach for assessing noncancer risks associated with hazardous compounds. The benchmark dose method is a more powerful statistical tool than the traditional NOAEL approach and represents a step in the right direction for a more accurate risk assessment. The benchmark dose method involves fitting a mathematical model to all the dose-response data within a study, and thus more biological information is incorporated in the resulting estimates of guidance values (e.g., acceptable daily intakes, ADIs). Although there is an increasing interest in the benchmark dose approach, it has not yet found its way into the regulatory toxicology in Europe, while in the United States the U.S. Environmental Protection Agency (EPA) already uses the benchmark dose in health risk assessment. Several software packages are today available for benchmark dose calculations. The availability of software to facilitate the analysis can make modeling appear simple, but often the interpretation of the results is not trivial, and it is recommended that benchmark dose modeling be performed in collaboration with a toxicologist and someone familiar with this type of statistical analysis. The procedure does not replace expert judgments of toxicologists and others addressing the hazard characterization issues in risk assessment. The aim of this article is to make risk assessors familiar with the concept, to show how the method can be used, and to describe some possibilities, limitations, and extensions of the benchmark dose approach. In this article the benchmark dose approach is presented in detail and compared to the traditional NOAEL approach. Statistical methods essential for the benchmark dose method are presented in Appendix A, and different mathematical models used in the U.S. EPA's BMD software, the Crump software, and the Kalliomaa software are described in the text and in Appendix B. For replacement of NOAEL in health risk assessment it is considered important that consensus is reached on the crucial parts of the benchmark dose method, that is, selection of risk types and the determination of a response level corresponding to the BMD, especially for continuous data. It is suggested that the BMD method is used as a first choice and that in cases where it is not possible to fit a model to the data the traditional NOAEL approach should be used instead. The possibilities to make benchmark dose calculations on continuous data need to be further investigated. In addition, it is of importance to study whether it would be appropriate to increase the number of dose levels by decreasing the number of animals in each dose group.

Animals↗
PubMed1994

Clinical benchmarking improves clinical paths: experience with coronary artery bypass grafting.

BACKGROUND: Clinical paths and clinical benchmarking are consistent with, and readily adaptable to, any health care organization that espouses the principles of continuous quality improvement. CLINICAL PATHWAY: In its initial clinical path project, Borgess Medical Center analyzed and streamlined the processes of caring for a coronary artery bypass graft (CABG) patient. Team discussions were driven by comparative data, specialty guidelines, peer review organization guidelines, patient financial statements, patient records, and the applicable literature. One year after the CABG clinical paths were implemented, average total charges to the patient dropped from $35,700 to $32,700. Average length of stay also dropped, from 11.1 to 9.7 days. The mortality rate held stable at 2.7%. CLINICAL BENCHMARKING: Recognizing the opportunity to further improve its CABG clinical path, Borgess participated in MediQual's CABG benchmarking project. The team followed MediQual's five phases of clinical benchmarking: focus and opportunity assessment, outcome analysis and comparison, clinical process documentation, benchmark process comparison, and action planning, implementation, and monitoring. Using benchmark data provided by MediQual, the CABG benchmark team focused on the high-risk population and identified further opportunities for streamlining the CABG clinical pathway. Several areas for improvement were identified by comparing Borgess's practices to the benchmark hospitals. CONCLUSION: Developing a clinical path before beginning to benchmark "forced" Borgess Medical Center to develop a clear understanding of its own processes. This allowed the benchmark team to easily identify variances between its CABG processes and those of the benchmark hospitals and to select which variations the hospital should adopt.

Clinical Protocols↗
PubMed1994

An introduction to benchmarking in healthcare.

Benchmarking--the process of establishing a standard of excellence and comparing a business function or activity, a product, or an enterprise as a whole with that standard--will be used increasingly by healthcare institutions to reduce expenses and simultaneously improve product and service quality. As a component of total quality management, benchmarking is a continuous process by which an organization can measure and compare its own processes with those of organizations that are leaders in a particular area. Benchmarking should be viewed as a part of quality management programs, not as a replacement. There are four kinds of benchmarking: internal, competitive, functional and generic. With internal benchmarking, functions within an organization are compared with each other. Competitive benchmarking partners do business in the same market and provide a direct comparison of products or services. Functional and generic benchmarking are performed with organizations which may have a specific similar function, such as payroll or purchasing, but which otherwise are in a different business. Benchmarking must be a team process because the outcome will involve changing current practices, with effects felt throughout the organization. The team should include members who have subject knowledge; communications and computer proficiency; skills as facilitators and outside contacts; and sponsorship of senior management. Benchmarking requires quantitative measurement of the subject. The process or activity that you are attempting to benchmark will determine the types of measurements used. Benchmarking metrics usually can be classified in one of four categories: productivity, quality, time and cost-related.

Outcome and Process Assessment, Health Care↗
PubMed2000

Using benchmarking data to evaluate and support pharmacy programs in health systems.

The use of benchmarking data to evaluate and support pharmacy programs in health systems is discussed. Benchmarking is a method of comparing the outcomes of health care products, services, and practices at an institution against those of competitors in order to learn what might be improved. Benchmarking programs can provide valuable feedback about both positive and negative outcomes. However, it is imperative to avoid inappropriate comparisons and inappropriate assessments. Ideal services for benchmarking are those that have a good likelihood of improving patient care and other outcomes. Successful benchmarking requires sound and thorough data, which is why as many health systems as possible should participate in a benchmarking program. The National Committee for Quality Assurance has formulated guidelines that should enable health systems to develop an information framework that will improve their ability to collect and use data for benchmarking. Standardization in collecting and submitting information is important because it enables institutions to share data easily. Benchmarking can help health-system pharmacists understand the value and outcomes of efforts by their colleagues at other institutions. In addition, benchmarking can help convince health-system administrators of the value of pharmaceutical services in terms of patient care and the bottom line. Benchmarking provides a means of evaluating and supporting the development of pharmacy programs that improve care and save money.

Benchmarking↗
PubMed1996

Benchmarking reference services: step by step.

This article is a companion to an introductory article on benchmarking published in an earlier issue of Medical Reference Services Quarterly. Librarians interested in benchmarking often ask the following questions: How do I determine what to benchmark; how do I form a benchmarking team; how do I identify benchmarking partners; what's the best way to collect and analyze benchmarking information; and what will I do with the data? Careful planning is a critical success factor of any benchmarking project, and these questions must be answered before embarking on a benchmarking study. This article summarizes the steps necessary to conduct benchmarking research. Relevant examples of each benchmarking step are provided.

Data Collection↗
PubMed1994

Collaborative benchmarking in a healthcare system.

Leading organizations outside of the healthcare industry have benefitted from benchmarking for more than a decade. In the last few years, healthcare organizations also have begun to use benchmarking to achieve breakthrough improvements in their performances. Most of these organizations have conducted their benchmarking studies independently, working one-on-one with outside benchmarking partners. More recently, some organizations have chosen to benchmark processes in conjunction with other healthcare organizations. This article discusses the application of a collaborative benchmarking project conducted by selected facilities within the Catholic Health Corporation (CHC). It reviews the rationale for implementing collaborative benchmarking efforts and the benefits such efforts bring to the organizations involved. Presentation of a work in process--a case study on workers' compensation--provides insights into collaborative benchmarking. The article focuses on the initial phases of the benchmarking process--selecting the project and establishing the benchmarking collaborative.

Catholicism↗