6 Steps for Successful Surgery Center Benchmarking

When ambulatory surgery centers compare their performance to benchmarks at other centers, they are satisfying accreditors and opening the door to their own self-improvement, says Bunny Twiford, RN, president of Twiford Consulting in Warminster, Pa. However, she says many ASCs do not do enough benchmarking or don't follow through with an improvement process.

 

Ms. Twiford says a center should undertake at least two benchmarking studies a year and she recommends four or five. Accreditors would like ASCs to benchmark a variety of areas, such as clinical, safety (including infection control), administrative and cost of care, but they don't get specific because they want each ASC to address its own particular problems, she says.

 

Here Ms. Twiford cites six basic steps the nurse manager or other designated ASC personnel should take when benchmarking.

 

1. Identify a problem or concern. The nurse manager should identify a problem or concern for the ASC. One example might be lack of patient compliance with "NPO instructions" restricting eating or drinking before a procedure, such as a colonoscopy. "Put a figure on the results," Ms. Twiford says. "How many patients did not comply and then, what was the percentage of compliance?" For example, the ASC may have had to cancel ten appointments over the past six weeks due to non-compliance with NPO instructions.

 

2. Set a goal. What level of compliance do you want to reach? The goal, expressed as a percentage, should be realistic. For example, you may want the percentage of patients complying with NPO instructions to rise a full 10 points from 82 percent to 92 percent. "You may need to go back and amend this goal once you know what other ASCs can achieve," Mr. Twiford says.

 

3. Survey other ASCs in the area. Hold phone interviews or send questionnaires to nurse managers at other ASCs. Five surgery centers should be sufficient. Ask for hard numbers that can be compared to your center, such as the percentage of patients complying with NPO instructions. Then ask for the methods each center used to improve compliance.

 

4. Summarize the results. Break out the percentages reported by each center, the rate for all the centers, and the rate for your center. Then summarize the various methods each center used to reach its compliance level. "Graphs are particularly effective in showing results," Ms. Twiford says.

 

5. Use the data to identify improvements. Some ASCs stop with data-collection, but this won't satisfy accreditation requirements or improve ASC operations. "It is not enough to collect the information," Ms. Twiford says. "You have to do something with it."

 

6. Test possible improvements. Possibly not all the successful improvements at other centers will work at your ASC. Test each of the more promising ones. This process could last several months. "When you find one or more methods that help you reach your goal, the study is complete," Ms. Twiford says.

 

7. Write a report. Collect the results and summarize them in a report to the ASC quality committee, the governing body and the staff. "Since site surveyors will examine the report later, document each step of the benchmarking process and the improvements that resulted," Ms. Twiford says. Date when the report was reviewed and approved by each group.

 

8. Consider a restudy later. You may want to study the problem again if your percentages start to falter or if conditions change and your methods are no longer effective.

 

Learn more about Twiford Consulting.

 

Read more about ASC benchmarking:

 

- 18 Statistics About Pain Management in Surgery Centers

 

- Surgery Centers Await Federal Rules on Quality Reporting

 

- 5 More Physician Statistics Surgery Centers Should Track and Benchmark

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