Improving surgical outcomes through benchmarking

Abstract

Benchmarking is a popular quality‐improvement tool in economic practice. Its basic principle consists of identifying the best (the benchmark), then comparing with the best, and learning from the best. In healthcare, the concept of benchmarking or establishing benchmarks has been less specific, where comparisons often do not target the best, but the average results. The goal, however, remains improvement in patient outcome. This article outlines the application of benchmarking and proposes a standard approach of benchmark determination in surgery, including the establishment of best achievable real‐world postoperative outcomes. Parameters used for this purpose must be reproducible, objective and universal. A systematic approach for determining benchmarks enables self‐assessment of surgical outcome and facilitates the detection of areas for improvement. The intention of benchmarking is to stimulate surgeons' genuine endeavour for perfection, rather than to judge centre or surgeon performance.

Hospital safety net burden is associated with increased inpatient mortality and postoperative morbidity after total hip arthroplasty: a retrospective multistate review, 2007–2014

“…60 Appropriate operative use of hospital benchmarking through reproducible, optimal, objective and universal patient measures can also drive surgical outcome improvement through adoption of best practices. 61 Establishing a national agenda for surgical disparities research will also help to find effective and innovative approaches to address disparities. 62 National anesthesia organizations, such as the American Society of Regional Anesthesia and Pain Medicine can play a huge role in mobilizing its membership to accomplish this goal; likewise relevant clinical journals can make it a priority to publish and promote such findings to raise awareness.…”

Correspondence

“…We read with great interest Pawel Mroczkowski's remarks on our publication. Unquestionably, we agree on his main message that patients and their perspective must be the focus of surgical outcome improvement.…”

Risk-adjusted benchmarks in laparoscopic liver surgery in a national cohort

“…First, a Bayesian estimator approach was used to adjust the rate for each centre based on sample size, and then a pared mean approach was used to pool the results from the top 10 per cent of the samples. By calculating the benchmark for very low‐risk patients, no conclusion can be drawn regarding the treatment of non‐benchmark patients. Unfortunately, the proportion of ‘benchmark patients’ is very low in real life.…”