Benchmarking to Root Out Variation and Improve Quality of Care

Variation in care is like a cavity. While no one likes going to the dentist, we all know it’s a necessity to monitor oral health and prevent potential problems. In care delivery, if variation isn’t treated at the onset, it can lead to serious issues including unnecessary or excess services, additional costs and diminished outcomes.

To root out variation while maintaining or improving quality, successful health systems are proving that robust benchmarking analytics are essential.

Broad benchmarking capabilities and transparency accelerates results.

Technology that can effectively compare and benchmark data on national, local, departmental and clinical performance is imperative for any initiative that aims to remove unjustified variation.

With a lens into the outcomes of top-performing healthcare organizations, a health system can compare its own outcomes and use that knowledge to create new sustainable improvement strategies. This information is even more valuable when providers can reach out to top performers to understand the best practices they implemented to achieve success.

For example, hospitals in Premier’s quality improvement collaborative work together to reduce variation and improve care quality across 37 states. Using robust clinical benchmarking and analytics tools, they transparently share, measure and compare their data to identify the top performers, assess outcomes and determine the improvement rate that can reasonably be expected based on the evidence collected. Top performers share best practices with the entire collaborative to help all participants close gaps in care, accelerate improvement and avoid reinventing the wheel. As a result, these collaborative members have saved more than 200,000 lives and $18 billion over nine years.

St. Luke’s University Health Network of Bethlehem, PA, offers another example of how benchmarking and transparency can help drive results. By reviewing performance data, discussing opportunities and sharing progress reports directly with post-acute care providers on a quarterly basis, St. Luke’s, an early leader in bundled payment, discovered it needed to restructure its care model. St. Luke’s embedded physicians and nurse practitioners in post-acute provider facilities and implemented interdisciplinary daily rounds, team meetings, new care pathways and alignment of treatment protocols, resulting in:

• A 22 percent reduction in skilled nursing facility (SNF) length of stay for patients in the bundled payment program;
• A 23 percent reduction in SNF readmissions; and
• A more than 50 percent reduction in SNF length of stay for total joint replacements alone

Benchmarking across services lines optimizes performance.

Benchmarking in the intensive care unit (ICU) enabled two Premier members to reduce length of stay and costs without compromising quality of patient care.

Charleston Area Medical Center (CAMC), a West Virginia-based health system comprised of four acute care hospitals and nearly 50 outpatient facilities, sought to improve Medical Intensive Care and ICU utilization in two of its hospitals. By analyzing Premier data on key performance indicators, CAMC found patients with conditions that typically required a three-day stay in the ICU at peer facilities were spending approximately 25 percent more days in the ICU at CAMC on average, with no discernable effect on outcomes. CAMC worked with ICU staff to standardize care, which successfully reduced length of stay in the ICU and Medical Intensive Care unit by 1.15 days over a 21-month period, as well as dramatically decreased deferrals.

Inova Fairfax, part of a five-hospital system within Inova Health based in Northern Virginia, also used Premier data to pinpoint variation in clinical practice and standardize care within the ICU. To understand current practice trends, the clinicians and the quality clinical effectiveness team leveraged Premier data and analytics to gain access to critical quality performance metrics, looking at the rates of complications, readmissions and length of stay associated with the Neurological ICU. To drill down on existing variation, Inova used monthly dashboards to highlight progress, and clinician scorecards to identify what was working and improvement opportunities. Within a 10-month period, the overall length of stay in their Neurological ICU was reduced from 5.2 days to 2.1 days, and patient readmissions to the ICU decreased by 54 percent.

Ready to harness the power of benchmarking analytics?

Successful hospitals and health systems have discovered the power of benchmarking analytics for optimal care delivery. Premier members are making great strides in pinpointing variation as well as the sources that are contributing to the problem, and working together to implement solutions that improve the overall cost and quality of patient care.

If you’re ready to put the power of benchmarking to work in your hospital or health system to drive real, sustainable performance improvement, contact us.