bENCHMARKING top tips
WHAT IS BENCHMARKING?
Perhaps the most common questions we regularly receive from department leaders is around productivity benchmarking. While many vendors provide peer performance comparison data to hospitals, the information is leveraged in the same way. This summer, we’ll explore the topic of productivity benchmarking and its many nuances. Please don’t hesitate to send us questions!
LEVERAGING DATA
High performing organizations understand that benchmark comparisons provide directional information about peer performance to support long-term, strategic decision making. In contrast, productivity management tools should be used to drive daily, bi-weekly, and monthly performance to budgeted targets.
A common mistake of inexperienced leaders is requiring performance to 50th percentile benchmark targets without ensuring the current department operations should perform to those targets. Leaders who manage to peer performance rather than budgeted targets run the risk of negatively impacting quality of care and strategic goals.
STATS MATTER
Benchmark synonyms! stat = statistic = volume = UOS (unit of service) = UOM (unit of measure)
All of these terms reference quantified workload measurement for a department over a given timeframe. When performing peer comparisons, it is critical to ensure the stat – or denominator in the worked hour per UOS – matches the definition required for submissions. For example, if an Operating Room submits OR cases when peers submit OR minutes for the reporting period, the department will certainly appear overstaffed compared to peers. Similarly, if an Emergency Department submits annual ER visits when peers submit quarterly ER visits, the department will certainly appear understaffed compared to peers. Accurate peer comparisons rely on all submitting organizations to follow defined parameters for both statistics and hours.
SELECTING STATS
Stat selection can be challenging for some departments - and using a singular statistic to describe workload is never perfect. However, some stats do a better job of describing workload in departments than others. As an example, Central Sterile departments commonly report OR minutes when comparing staffing to peers. However, in ORs with a higher proportion of orthopedic cases, tray counts may tell a different story. It is important to remember that peer comparison benchmarks provide information about our performance compared to our peers. That information can be colored very differently, depending on the stat chosen for comparison. This is a critical concept to consider when using benchmark data to address departmental perceived efficiency opportunities.
NORMALIZATIONS MATTER
Know your benchmark compare group definitions! If your department includes non-standard functions, be sure to normalize. For example, if your emergency department cost center includes registration FTEs, it's important to assign these FTEs to the registration department for accurate benchmark peer comparisons.
UN-BENCHMARKED FTEs
Very few FTEs are appropriate to not be benchmarked. Industry best practice is to review un-benchmarked FTEs annually for appropriateness.
PERFORMANCE GOALS
Know your benchmark compare group definitions! If your department includes non-standard functions, be sure to normalize. For example, if your emergency department cost center includes registration FTEs, it's important to assign these FTEs to the registration department for accurate benchmark peer comparisons.
LOW PERFORMANCE OUTLIER
While lowest performance is commonly tagged as "best", in actuality it is an outlier and should be evaluated for accuracy. Common drivers of low outliers include reference labs, centralized order entry for pharmacy, any outsourced function where FTEs aren't being counted, and ancillary test credit for test nursing staff performance.
HIGH PERFORMANCE OUTLIER
While highest performance is commonly tagged as "worst", in actuality it is an outlier and should be evaluated for accuracy. Common drivers of high outliers include lock-in, fixed hours of operation for low volume areas, minimum staffing requirements such as L&D, and covering services outside of your peer group definition.
CREATE AN ACTION PLAN
If you only picked up one tip from this entire series, we hope it is this one. Before adjusting a productivity target, develop an action plan and demonstrate results. Always consider the impact to other success metrics - such as patient satisfaction, quality care, staff effectiveness, market dynamics, and physician engagement before formalizing a change.