This article is written by Julie Jung, RN, MSN, VP Clinical Services and Accreditation for Outpatient Strategies & ASC Strategies.There are a number of different stories about the origin of the term "benchmarking," including one that links the first use of the term to shoe cobblers. Cobblers would take a person's foot and place it on a bench. They would then make marks on their benches to designate a certain size. This "bench mark" was used for comparison and helped ensure shoes of a particular size would fit clients.
ASCs also use benchmarks as a means of comparison. External benchmarking, which is a comparison of an ASC's performance against the performance of other ASCs and providers, is a particularly effective method to analyze an ASC's performance, identify areas for improvement and validate processes. Benchmarking is also a regulatory compliance requirement. Medicare, state agencies and accrediting bodies mandate this activity to ensure centers are evaluating ways to provide efficient, effective and safe patient care.
Many ASCs struggle to identify topics for worthwhile benchmarking studies. Follow these five strategies to come up with strong ideas for consideration.
1. Ask the organization's governing board for benchmarking suggestions. It is a Medicare requirement that a surgery center's governing body has complete oversight of the organization, including the receipt of a benchmarking activities report. During governing board meetings, it would be appropriate to ask about ideas for formal benchmarking. Is there something the physicians would like reviewed and compared?
When board members are involved in suggesting benchmarking activities, they may be more interested in the results, and more likely to participate in development and implementation of improvements if needed.
2. Ask the ASC staff for benchmarking suggestions. As with governing board meetings, when there are staff meetings, ask employees if they have suggestions for benchmarking topics. During the usual business of a staff meeting, as reports are presented, this might trigger ideas based on the topics of discussion. In addition, encourage staff members to bring ideas to future meetings.
Note: If an employee suggests a benchmarking topic because of a specific event or a change seen in quality indicator data, before developing a benchmarking activity around the topic, first determine whether these events are indicative of an ongoing trend and indeed worthy of more attention or if an isolated incident is to blame.
3. Identify topics through surveys and reports. Benchmarking ideas don't necessarily have to be presented verbally. They might also be found in writing.
Look for potential topics when reviewing patient, physician and employee satisfaction surveys; infection/complication surveys from physicians; and any other center-specific reports, including those related to financials. Benchmarking doesn't have to be — and shouldn't just be — related to clinical areas.
4. Participate in large benchmarking projects. There's certainly nothing wrong with benchmarking an organization's performance against a single or few ASCs, but this will only provide a small sample size. By participating in benchmarking activities with hundreds of organizations, there is a much larger population with which to compare the ASC.
For example, the ASC Association has an Outcomes Monitoring Project, which has more than 650 participants and provides benchmarks for more than 40 key indicators. The accreditors often have benchmarking activities, such as those developed by the AAAHC Institute for Quality Improvement. There are also companies that provide benchmarking services to ASCs, such as Voyance (formerly CTQ Solutions), Surgical Outcomes Information Exchange and Press Ganey.
5. Make comparisons with specialty society data. Benchmarking activities do not need to always compare the entire ASC's performance. An excellent external benchmark is using the performance metrics of specialty organizations. One can often find data from societies about specific procedures. For example, when comparing tourniquet time for knee arthroscopies, it would be appropriate and meaningful to review what national orthopedic associations have discovered thru their collection of this data.
Make benchmarking an ongoing effort
Benchmarking — whether it is internal or external — is not an activity to be performed once a year or conducted just to meet regulatory requirements. To achieve and maximize the benefits of benchmarking, ASCs should constantly and consistently work on their benchmarking. This includes data collection and analysis as well as identifying new opportunities for strong benchmarking activities. ASCs that make benchmarking a priority are more likely to identify areas in need of change and achieve significant improvements in all aspects of their operations over time.
Julie Jung can be reached at jjung@ascstrategies.com or www.ascstrategies.com.
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