The following article appeared in the May. 2011 issue of Connection, the e-newsletter from the AAAHC.
Q: AAAHC Standard 5.II.A-6 refers to performing internal and external benchmarking to support the QI program goals. The 2011 Handbook's Glossary defines internal benchmarking as a comparison of "performance within an organization, such as by physician or department, or over time. For the purposes of accreditation, the internal benchmarking standard does not apply to organizations with fewer than three practitioners." What are some meaningful activities and suggestions that would allow smaller organizations with less than three practitioners to benefit from an internal benchmarking effort?
Raymond Grundman, MSN, MPA, AAAHC Senior Director, External Relations & AAAHC Surveyor: The term benchmark originally comes from surveying where it was used to denote a notch or mark representing a given altitude, and against which other heights could be calibrated or 'benchmarked.' Since then, it has come to mean any standard against which something is compared. Essentially it involves learning, sharing information and adopting best practices to bring about step changes in performance.
Internal benchmarking is looking at the differing levels of performance within your own organization and highlighting best practices for dissemination to other parts. For example, if an organization has several departments scheduling appointments then it can analyze the best performing areas in each and extrapolate these features to its other operations, thus bringing all operations up to the best internal levels of operation.
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The benefits of internal benchmarking are that it is cost effective; that it is easy to gain access to all the information required; and that it does not require you to share practice information with outside parties. 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.
Examples of Internal Benchmarking are
- Productivity: the number of operative reports a coder can code, the number of claims payments an A/R clerk can post, the number of prescriptions a pharmacist can fill in "x" time
- Quality: number of complications per 100 surgeries, internal lab specimens proficiency testing, repeat radiology film analysis
- Time: admit-to-discharge time for specific visits, draw time to results available time for stat tests, release of information lag time
- Cost-related: comparison of preference card costs among similar specialists for the same procedure, number of days inventory on hand, number of turns in pharmacy or medication inventory
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