6 things hospitals can overlook when benchmarking
Tips that can help organizations looking to manage performance with data-driven insights
By Kathy VanEnkevort | 3 minute read | December 17, 2019
To succeed in value-based care programs, hospitals need to take a hard look in the mirror to understand where they are strong, and where there is the opportunity to improve. The challenge is that we (humans) aren’t good at looking in the mirror objectively. We make excuses, tell stories, or simply deny. In healthcare it’s even more difficult; we’re dealing with an incredibly complex and interdependent system.
Benchmarking helps hospitals and health systems evaluate themselves against a standard, usually considered ‘the best,’ in hopes of understanding how well they are doing and where they can do better. In my years of experience working with hospitals and health systems, I’ve found that most organizations have embraced benchmarking to help improve their decision-making and mitigate related financial consequences.
Below, I’ve focused on my view of the six key elements in benchmarking that may help organizations go from just reporting the news to actually changing the headlines:
1. Pay attention to the underlying processes.
Rather than focus on the symptoms, it’s important to get to the root of the problem. We must examine cause-and-effect relationships more today than ever. The business of healthcare and the provisioning of healthcare now have interconnected strategic aims. As we move from fee-for-service to value-based care, seeing all the components of the value equation can help bring the fragmented practices of today into the fluid continuums of tomorrow.
2. Prioritize initiatives that can help solve multiple challenges.
Keep asking “why?” and always demand that the initiative can solve multiple challenges—that’s the essence of intelligent information vs. just information. For example, wanting to improve the length of stay is a big task as there are many components— Did they stay longer due to complications? Was it a weekend stay? Were there delays in the diagnostics or the treatment modalities? Were there patient preferences? We know that patients experiencing sepsis stay longer, have increased mortality and morbidity, and cost more.1 Whatever you are solving for should have a ‘triple ripple effect.’
3. Don’t overlook what makes you different – account for it.
Each organization, department, provider, and patient is unique. But all too often, performance improvement initiatives are stifled by the collective groan “you can’t compare me, I’m different.” Successful organizations have learned to account for these differences and then figure out which of those differences help, or hinder performance. It is essential to adjust for the risk and severity of patients as well as normalize for the characteristics of the environment in which they are served. Comparing unadjusted event rates for different hospitals could unfairly penalize those caring for higher-risk patients and in settings that are fundamentally different.
4. Engage leadership early and often.
Benchmarking exercises require significant time and effort, and the whole team must be on board. Optimal accomplishment happens when all are aligned on the same goals and marching forward in tandem, each recognizing their contribution to the ‘dot’ mapped on a scorecard. Getting department managers buy-in upfront will also help facilitate the effort as they’re often the muscle that executes on the initiatives. A lack of any connection between the data effort and business priorities from top to bottom can lead to no lasting organizational impact.
5. Build-in accountability mechanisms.
Reporting the news and changing the headlines are two different things. The transition from measuring to acting can elude even the most progressive organizations. To encourage accountability and engagement, identify targets that are actionable and hold teams accountable for incorporating results into their daily operations. Most organizations don’t get far on their journey, in my experience, not because they aren’t measuring the right things, but because the culture isn’t aligned. Also, don’t forget to celebrate wins and appreciate the progress made.
6. Expect accuracy to require effort.
The low-hanging fruit fell off the tree years ago, so organizations need a more powerful ‘detector’ to bring visibility to what has been invisible. Most of the next level of improvement will come from something you cannot see today. For comparative benchmarks to bring continued insight, even fractions of performance must be identified and exposed. That comes from a large denominator and a trusted single source of truth that enables the statistically significant insight to rise.