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Excerpt
To effectively cope with the growing pressures of the constantly changing healthcare environment, nurses are being asked more and more to reduce costs while maintaining high-quality patient care. This is a very real expectation of the entire hospital organization as managed care alternatives and capitation work their way into healthcare organizations. Hospitals that have not found ways to provide low-cost, high-quality patient care will not survive in the long term. They should begin now to build a benchmarking model of process improvement into the existing Total Quality Improvement framework. Many hospitals across the nation have been successful using this model to improve processes, change work habits, and move toward a strong, flexible organization ready for increased competition and managed care constraints. They have used benchmarking for productivity improvement, customer satisfaction, clinical cost management, and strategic and financial planning.
Healthcare is not the only industry required to respond to market challenges that require high efficiency and low cost. The quick printing industry, the airline industry, and the automotive industry have all been forced to face the challenges of competition. These industries have met that challenge by incorporating benchmarking into their corporate plans and have set the standard for others to follow. The use of best practice-benchmarking-was pioneered by the Xerox Corporation in the late 1970s and has become commonplace in healthcare in the last 5 years. The ten-step model for benchmarking developed by Xerox2 can be applied in health care organizations as follows:
1. Identify what is to be benchmarked. This can be achieved by comparing length of stay (LOS), costs per surgical case, patient satisfaction by using the organization's evaluation methodology such as Press-Ganey reports, costs per day, and nursing costs per day.
2. Identify benchmarking partners. Identify other successful organizations, including those outside the healthcare industry.
3. Determine data collection methods and collect the data. Examine your demographics and identify the most appropriate sources across the nation with whom you should compare your unit. Be certain to set "stretch" goals. Remember, this is serious business to your patients and to your organization's future.
4. Analyze the data collected and determine current performance level. Compare the organization's performance with the performance of the benchmarked organizations. This is accomplished by looking at your nonsalary costs per patient day on your unit and comparing this information to the nonsalary costs of a hospital similar to yours.
5. Project future performance levels. Do not stop with your cost-saving efforts, even if you reach the 20th percentile (best practice) on the benchmarking charts.
6. Communicate benchmarking findings. Benchmarking should be shared with all employees across all levels of the organization. It is important that every employee in the healthcare facility know and understand the results of the benchmarking data.
7. Establish functional goals by writing objectives. These objectives should be written with input from the staff of each nursing unit.
8. Develop action plans to reach objectives. All staff members on the unit should have a voice in developing these plans. Otherwise, it will not be their plan and they will not feel obligated to help achieve the goals.
9. Implement the plans and monitor progress. Once a new process or cost-saving method has been implemented on a nursing unit, it is imperative that the activity be monitored and continuously assessed to determine the cost savings and improvement in quality achieved.
10. Recalibrate measurements.
