Benchmarking for Health Care
MCHS Medical Library Pathfinder

INTRODUCTION
This pathfinder leads the way to select databases, electronic resources, books and articles, and other key library resources relating to benchmarking in health care. If you know of other quality benchmarking resources which should be included, please let the Medical Library know. (Medical.LibraryMC@mosescone.com)

Benchmarking Glossary, from Creative Ideas and based on one published by the Benchmarking Exchange

An Introduction to Benchmarking
The purpose of this 2000 document is to provide a general introduction to benchmarking. It reviews what benchmarking is, why we need to benchmark, the types of benchmarking that can he used, and illustrates the major steps involved in a benchmarking project.

Successful Database Benchmarking: What Do We Need? Richard B. Backiel II, BS Journal of Healthcare Information Management, Vol. 15, no. 2, Summer 2001
This article educates and informs healthcare facilities about the factors that should be considered when comparing their own data with those of other hospitals in an on-line benchmarking database warehouse.

Baldridge National Quality Program, National Institute of Standards and Technology.
“The Baldrige Award is given by the President of the United States to businesses … and to education, health care and nonprofit organizations that apply and are judged to be outstanding in seven areas: leadership; strategic planning; customer and market focus; measurement, analysis, and knowledge management; human resource focus; process management; and results.” This site offers information about this award and the application process.


DATA SETS
Ambulatory Health Care Data
CDC’s National Center for Health Statistics Ambulatory Health Care Data site offers information on the NAMCS (National Ambulatory Medical Care Survey) and the NHAMCS (National Hospital Ambulatory Medical Care Survey). Data highlights include physician office visit data, outpatient visit data, emergency department visit data, and ambulatory care data from Health, United States, 2000. Also available are public-use data files.

Agency for Healthcare Research and Quality, Rockville, MD (301) 427- 1364
The Agency for Healthcare Research and Quality's (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Information on this site includes Clinical Information, Funding Opportunities, Research Findings, Quality & Patient Safety, specific population groups, and Data and Surveys.

Healthcare Cost and Utilization Project,  HCUPNet
HCUPNet, a service of the Healthcare Cost and Utilization Project, is an on-line query system that gives “access to health statistics and information on hospital inpatient and emergency department utilization.”  HCUPnet's step-by-step query system allows you to generate tables and graphs on national and regional statistics and trends for community hospitals in the U.S.

AHRQ National Quality Measures Clearinghouse
The National Quality Measures Clearinghouse provides information on specific evidence-based health care quality measures and measure sets. It contains a glossary of terms used in the standardized abstracts and sections on "Using measures" and "Selecting measures."

AHRQ Quality Indicators
The AHRQ Quality Indicators series, which includes the Inpatient Quality Indicators (IQIs), Prevention Quality Indicators (PQIs), Patient Safety Indicators (PSIs), and Pediatric Quality Indicators, are measures of health care quality that make use of readily available hospital inpatient administrative data.

2007 National Healthcare Quality Report (NHQR)
This is a comprehensive national overview of the quality of healthcare in the United States and is a companion report to the National Healthcare Disparities Report.  The NHQR is built on 218 measures assembled across four dimensions of quality - effectiveness, patient safety, timeliness, and patient centeredness.  The 2007 report focuses on the state of health care quality for a group of 41 “core” report measures.  The purpose of the report is to track the state of health care quality for the Nation on an annual basis.

The Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services (CMS) (formerly the Health Care Financing Administration) administers the Medicare program, and works in partnership with the States to administer Medicare, Medicaid, the State Children's Health Insurance Program (SCHIP), and HIPAA (Health Insurance Portability and Accountability Act), CLIA (Clinical Laboratory Improvement Amendments), and several other health-related programs. The section for Research. Statistics, Data, and Systems  provides a number of data sets.

The Leapfrog Group
The Leapfrog Group is a consortium of public and private organizations that provide health care benefits for their employees.  The mission of The Leapfrog Group is to encourage advancements in safety, quality and affordability of health care by “supporting informed healthcare decisions by those who use and pay for health care and promoting high-value health care through incentives and rewards.” Brief comparative data, geared for the consumer, from the Leapfrog Hospital Quality and Safety Survey is available at: http://www.leapfroggroup.org/cp.  All hospitals are welcome to participate in the Survey.

National Center for Health Statistics, Hyattsville, MD (301) 458-4636
The National Center for Health Statistics of the Centers for Disease Control and Prevention is the nation’s principal health statistics agency, compiling statistical information to guide actions and policies to improve the health of the American public.  The National Health Care Surveys (NHCS) are a family of provider-based surveys designed to meet the need for objective, reliable information about the organizations and providers that supply health care, the services rendered, and the patients they serve. These NHSC Surveys include:

North Carolina Center for Health Statistics
SCHS is responsible for data collection, health-related research, production of reports, and maintenance of a comprehensive collection of health statistics to provide high quality health information for better informed decisions and effective health policies. The State Center is responsible for collecting, analyzing, and disseminating timely, comprehensive, and accurate health statistics. It is a central collection site for information about cancer, birth defects, births, deaths, marriages, and divorces.


ORGANIZATIONS
Many professional organizations have benchmarking information and data pertinent to their own discipline. Be sure to check the web site of your own professional organization.

The Advisory Board Company
The Advisory Board provides, for its members, services which include research, executive education and leadership development, decision-support tools, and consulting. The Advisory Board Company serves more than 2,600 health care organizations across 15 different best practices membership programs. Strategy and operations research provides forecasting and best practice research tools and expert consultation on the strategic and operational topics of greatest relevance to current industry challenges. Clinical research provides forecasting and best practice research tools and expert consultation on the clinical topics of greatest relevance to current industry challenges. The Advisory Board Academies provide leadership performance and management education dedicated to elevating the performance of partner organizations. Compass programs provide innovative Web-based business intelligence tools which provide members with real-time decision support, robust data collection, advanced analytical capabilities and quantitative research. OptiLink offers a fully integrated, web-based workforce management solution, providing both individual hospitals and enterprise-wide health care systems with the automated scheduling, acuity, and productivity technology needed to manage a scarce and dynamic workforce.  The Advisory Board Company also offers H*Works, a program which assists hospitals in installing exceptional management practices identified by Advisory Board research. 

American Productivity and Quality Center
This membership organization, APQC, works with its member organizations to identify best practices, discover effective methods of improvement, and broadly disseminate findings. The APQC Knowledge Base provides access to thousands of articles, case studies, presentations, and more. Limited free access to the APQC Knowledge Base and some for-a-fee content is available for non-members.

American Society for Quality, Central North Carolina Section 1109.
The mission of the Central North Carolina Section of ASQ is to promote the use of the principles and tools of Total Quality in Central North Carolina businesses and public institutions, and to be a comprehensive source of quality-related information to our membership and community.

Association for Benchmarking Health Care
A service of The Benchmarking Network, the ABHC was created to share benchmarking information. The purpose is to identify "Best in Class" business processes, which, when implemented, will lead member companies to exceptional performance as perceived by their customers. Membership is free.

Accreditation Association for Ambulatory Health Care
The Accreditation Association, a private, non-profit organization, currently accredits over 3,000 organizations in a wide variety of ambulatory health care settings, including ambulatory and office based surgery centers, managed care organizations, as well as Indian and student health centers, among others.  It develops standards to advance and promote patient safety, quality and value for ambulatory health care through peer-based accreditation processes, education and research. Accreditation is ultimately awarded to organizations that are found to be in compliance with the Accreditation Association standards.

The Joint Commission on Accreditation of Healthcare Organizations – Quality Check.
Quality Check is a comprehensive guide health care organizations and programs (Joint Commission accredited or non-accredited) throughout the US.  Quality Check provides information about the comparative performance of these organizations, including hospital performance measure results, free through access to Quality Reports.  Quality Reports contain relevant and useful information about the quality and safety of Joint Commission-accredited organizations.

Hospital Compare
This US Department of Health and Human Services tool provides information on how well the hospitals in a defined geographical area care for all their adult patients with certain medical conditions, focusing on heart attack, heart failure, pneumonia and surgical infection prevention. Hospital Compare has quality measures on how often hospitals provide some of the recommended care to get the best results for most patients. Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS) and organizations that represent hospitals, doctors, employers, accrediting organizations, other Federal agencies, and the public. Under the tab, Data Details, there is information on the data and how it is collected, for the professional as well as for the consumer.

Institute for Healthcare Improvement
The Institute for Healthcare Improvement (IHI), a not-for-profit organization, is designed for health care providers and organizations that are seeking to improve the care they give.  IHI provides training opportunities, many of which are web-based. The IHI Topics (Critical Care, End Stage Renal Disease, HIV/AIDS, Medical-Surgical Care, Patient-Centered Care, Patient Safety, etc) are the core around which content is organized. Each Topic features the best available knowledge for improvement in that area, including tools, literature, and changes that can be implemented and measured to help speed improvement in the organization.


DATABASES
Most of these databases provide access to the literature of the field.

The Cochrane Library
The Cochrane Library is a unique source of reliable and up-to-date information on the effects of interventions in health care. The Cochrane Library consists of a regularly updated collection of evidence-based medicine databases:


The Cochrane Database of Systematic Reviews A systematic review identifies an intervention for a specific disease or other problem in health care, and determines whether or not this intervention works.

Database of Abstracts of Reviews of Effectiveness  DARE contains abstracts of systematic reviews that have been quality-assessed. Each abstract includes a summary of the review together with a critical commentary about the overall quality.

The Cochrane Central Register of Controlled Trials  The CCRCT includes details of published articles taken from databases and other published and unpublished sources. CCRCT records do not contain the full text of the article.

The Cochrane Methodology Register. The Cochrane Methodology Register is a bibliography of publications which report on methods used in the conduct of controlled trials. CMR records contain the title of the article, information on where it was published (bibliographic details) and, in some cases, a summary of the article. They do not contain the full text of the article.

Health Technology Assessment Database.  The HTA database brings together details of completed and ongoing health technology assessments (studies of the medical, social, ethical and economic implications of healthcare interventions) from around the world. The aim of the database is to improve the quality and cost-effectiveness of health care.

NHS Economic Evaluation Database. Information about both costs and effects are essential to making evidence-based decisions about competing healthcare interventions.

Access to the Systematic Reviews, DARE, and the CCRCT are available, without a password, the MCHS Medical Library website, Medline (Ovid) when on a MCHS campus.

CINAHL – CINAHL is available from on campus through the MCHSL Medical Library homepage and choose “CINAHL (Nursing)”.  (No password is needed when on campus.)  The Cumulative Index to Nursing & Allied Health (CINAHL) database provides coverage of the literature related to nursing and allied health.  Some citations link directly to the full text of the article.

MEDLINE – Medline is available through Ovid from on campus or through NLM’s PubMed. Access both through the MCHSL Medical Library homepage. MEDLINE is the U.S. National Library of Medicine's database covering the fields of medicine, nursing, dentistry, the health care system, and health services administration. The full text of some articles is available.

HEALTH BUSINESS COLLECTION, Available through the AHEC Digital Library,
Database of 130 full-text business, health care, and health business journals. Access to this resource is available for MCHS employees or for NC health care practitioners through a paid membership in the AHEC Digital Library.  Please contact the Moses Cone Health System Library for further information.

 

NCLive is a collection of databases and full-text journals and newspapers. No password is needed if accessed from the MCHS Libraries or any NC public library. Access is freely available to NC citizens with a public library card. Check with the MCHS Library or your public library for instructions how to get this access. Databases include:

US Government Statistical Resources: to locate the agency or dataset you need try:

USA.gov is the official gateway to all US government information. The link to Data and Statistics is found on the Reference and General Government page.

SearchGov  This site allows you to search Federal or State governmental agencies.

FedStats is the gateway to statistics from over 100 federal agencies.


NEWSLETTERS
Ebenchmarking
EBenchmarking, a service of The Benchmarking Network, is an newsletter provided via e-mail and available free to individuals employed by corporations or governmental entities who are involved with benchmarking.  It is intended to provide information about benchmarking to the business community, including information about new benchmarking studies.

Healthcare Benchmarks and Quality Improvement
Monthly newsletter. American Health Consultants. The print copy is available in the MCHS Medical Library, Cone campus. Emailed Table of Contents of each issue is available; contact the Medical Library for this service.

Modern Healthcare
The journal Modern Healthcare is a source of healthcare business news that provides hospital executives with up-to-date and comprehensive healthcare news. Modern Healthcare also publishes a daily e-mail newsletter, Modern Healthcare’s Daily Dose. For alerts to news as it happens, Modern Healthcare Alerts emails or RSS news feeds are available. The emailed Table of Contents of each issue is available from the MCHS Medical Library; contact the Medical Library for this service.

 

PUBLICATIONS / REPORTS FOR PURCHASE
American Medical Association, Chicago (312) 464-5000

The Physicians Consortium for Performance Improvement
The mission of the AMA Physicians Consortium for Performance Measurement includes improving patient health and safety by identifying and developing evidence-based clinical performance measures that enhance quality of patient care and that foster accountability.

Fasttrakk Benchmarking Studies. The Benchmarking Network
A service of the Benchmarking Network, Fasttrakk studies are “focused on real measures from selected companies to fulfill short-term requirements.”Their purpose is to identify "Best in Class" business processes, which, when implemented, will lead member companies to exceptional performance

Solucient: 100 Top Hospital Studies
Among other benchmarking products, Solucient publishes the 100 Top Hospitals Results products.  Available products include the Cardiovascular Benchmarks for Success, National Benchmarks for Success, and Performance Improvement Leaders.  

Healthgrades: Guiding America to better healthcare.
Health Grades, Inc. (NASDAQ:HGRD) is a healthcare ratings, information, and advisory services company whose mission is “to guide America to better healthcare.” Healthgrades provides ratings and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans and hospitals. Consumers can find free hospital information on this site, including how they are rated.

 

SIX Sigma
Making Customers Feel Six Sigma Quality
A brief overview of the Six Sigma process, from GE. This site also includes brief descriptions of the Key Elements of Quality, the Six Sigma Strategy, and a Six Sigma Glossary of Terms and Definitions.

6 Sigma Health Care Benchmarking Association
The 6 Sigma Health Care Benchmarking Association (6SHCBA™), a service of the Benchmarking Network, is an association of 6 Sigma professionals within major health care companies and provides members with an opportunity to identify, document and establish best practices through benchmarking to increase value, efficiencies, and profits.

iSixSigma.
isixSigma provides free information resources designed to help business professionals successfully implement quality within their organizations. There are several free newsletters offered (including one for healthcare), Six Sigma Q & A, a dictionary, discussion forums, a SixSigma calculator, news items (with a RSS feed), links to Six Sigma events, and “channels” for various topics, including Healthcare and Financial Services. (A PDF version of iSixSigma information is here.)

 

Updated: 12/08