www.nursingmanagement.com January 2003 Nursing Management 19

D o you really know how yourhospital matches up to otherhealth care organizationsboth locally and nationally?

Do conversations with your col -leagues provoke the question,

“What’s everyone else doing?” Thistype of critical and informed think-ing about what benchmarkingmeans to an organization and howit’s accomplished is key to the suc-cess of any hospital.

Commonly confused with marketre s e a rch, benchmarking isn’t simplycomparing one hospital to another. Itinvolves measuring the performanceof an existing process, which enablesmanagers to target impro v e m e n te fforts that eventually yield bestp r a c t i c e s .

Drivers of the movementO r i g i n a l l y, hospitals used internala p p roaches to improve performance.

But organizations are quickly learningthat high-quality data has replaced theonce held “trust” in health care deliv-e r y. Legislation and market re f o r mheighten the pre s s u re for quality ande fficiency; accreditation bodiescontinually target for consistent cares t a n d a rd s .

A growing number of employersalso collect their own data, for exam-ple from litigation claims. Con-sumers are more aware of hospitalquality indicators, such as morbidityand mortality. Even a health systemwith an overall excellent reputationcan be negatively impacted by pooroutcomes from one or more of itsfacilities when contracting for man-aged care .1

If an organization can’t demon-strate its own quality care measures,it risks losing patients and managedcare contracts.2 This has propelledbenchmarking into the realm ofcommon business practice for for-

By My N. Tran, RN, MSN

Reach best practice statusby heeding operationalstrengths and weaknesses.

1.5ANCC/AACN CONTACT HOURS

CE

Abstract: Reposition and revitalize your

organization by teaching staff members to

use data for identifying, setting, and direct-

ing performance goals.

[Nurs Manage 2003:34(1):18-24]

ward-thinking health care organiza-tions, which use it as a tool toenhance their leverage withinindustry markets.

Benchmarking overview First used as a management tool bythe Xerox Corporation in the late1970s, benchmarking was designedto improve organizational perfor-mance through systemwide identifi-cation and implementation of bestpractices. Xerox’s formal definitionof benchmarking is “the continuousprocess of measuring products, ser-vices, and practices against the com-pany’s competitors or those compa-nies renowned as industry leaders.”3

Benchmarking efforts targeted atspecific concerns, such as impro v i n gmedication error rates or decre a s i n gpatient waiting times, are known asp ro b l e m -based benchmarking. Morerecently, facilities turn to process-based benchmarking, which entails tar-geting continuous improvement ofkey processes. This process-basedapproach is the current focus ofhealth care’s quality improvement(QI) movement.4

Managers can benchmark to helpdecide a variety of factors: where toallocate re s o u rces more eff i c i e n t l y,when to seek outside assistance, howto quickly improve current operations,whom to re w a rd for performance,whether customer re q u i rements arebeing adequately met, and whetherf u t u re goals are worthwhile ora c h i e v a b l e .5

For example, one hospital examinedits costliest surgical pro c e d u re anddetermined that lengthy pro c e d u retimes and scheduling drove up theprice. The hospital reduced averagecase length with a critical pathway,w h i c h :♦ streamlined patient registrationand transportation♦ incorporated pre o p e r a t i v ee v a l u a t i o n s♦ clarified staff responsibilities.

Implementation improved patientoutcomes, increased surgical effi-ciency, and cut nursing overtime.

Benchmarking pioneers believethat the tool serves four mainfunctions: 1. Analysis of the operation: Bench-marking firms must assess thestrengths and weaknesses of theircurrent work processes, analyze crit-ical cost components, consider cus-tomer complaints, spot areas forimprovement and cycle time reduc-tion, and find ways to reduce errorsand defects or to increase assetturns.2. Knowledge of competition andindustry leaders: Benchmarkingfirms must find out who’s the “bestof the best.”3. Incorporation of the “best of thebest”: Benchmarking firms mustlearn from leaders, uncover wherethey’re going, learn from the leaders’

superior practices, including whythey work, and emulate these bestpractices.4. Established superiority: Bench-marking firms must strive to becomethe new benchmark.6

The actual processAlthough there’s a variety of bench-marking processes available, only afew are tailored to the health careindustry. These include early initia-tives by small health care organi-zations such as the SunHealthAlliance, Catholic HealthCorporation, and VoluntaryHospitals of America, Inc.7

The following process is adaptedf rom the Baxter Benchmarking Model,8

which is divided into two parts, asfollows: 1. Preparation phase:♦ Select goals. Choose whatprocess(es) you’ll benchmark andwhat goals you’ll achieve. It’s impor-tant that this decision is made at ahigh level. Why? For benchmarkingto succeed, your organization’s topleadership must support theseefforts, which helps establishmomentum and ensure effectivedelivery.9

Put together a team that includesexecutives and medical and nursingleaders to define your goals. Andremember, your objective isn’t neces-sarily finding the lowest cost—con-sider financial and nonfinancial mea-sures. In addition, ensure that yourprocess remains definable and com-mon to many organizations, cross-functional, repetitive, measurable,and aligned with your facility’sstrategic plan.10 Some examples ofprocesses that organizations chooseto benchmark include improvingemergency department flow, expe-diting claims processing, and reduc-ing length of stay for high-volumeprocedures.11

♦ Identify resources. P re p a re a list ofre s o u rces—including personnel and

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B e n c h m a r k i n g

For benchmarking tosucceed, your

organization’s topleadership must

support these efforts,which helps establish

momentum and ensureeffective delivery.

stakeholders—that you’ll need. Keep inmind that you may need to train thesep roject team members in benchmark-ing methods and team managementskills. Get your executive teaminvolved in this step because they’rethe ones who need to definitively com-mit the re s o u rces and facilitate access tosensitive information. The executiveteam should be aware of all involvedc o s t s — p u rchase of benchmarkingdata, information systems, and exter-nal consultants—and be convincedthat the project’s final product willjustify these costs. ♦ Set timeframes. Develop a time-frame that includes start and com-pletion dates for each step involvedin the process. Your detailed work-plan should include expected datesof key deliverables. Also hold week-ly meetings to encourage active com-munication between the executiveteam and project members regardingupdates.♦ Define processes. It’s crucial that

your organization maintains a clearunderstanding of its own currentprocess. This will help evaluatethose steps that are necessary andthose that are unnecessary and prob-lematic. Consider using QI toolssuch as process flow charts andcause-and-effect diagrams.12 Policiesand procedures and critical path-ways are also useful to stimulatedialogue.

Involve staff members who workclosely with the process because theseindividuals will most likely beinvolved in future implementatione fforts. For example, nurse managerscan schedule a meeting with their staff sto outline the current process. This willp rovide greater detail of what actuallyhappens in the process, as well as pro-mote active participation within theo rganization. Once you’ve establishedan outline, make revisions to the cur-rent process using the group’s cre a t i v es u g g e s t i o n s .♦ Establish measures. Define indi-

cators to measure performance.Choose the most important, quantifi-able steps in the process for analysisof how they relate to the organiza-tion’s strategic mission, vision, andbenchmarking objectives. Some limi-tations to the range of available indi-cators may exist, as your organiza-tion may not currently be collectingthis data.13 Examples of indicatorsinclude time cycles, costs, lengths ofstay, staffing ratios, satisfaction rates,and error/compliance rates.Remember that you’ll ultimately useselected indicators to define animprovement as a result of thebenchmarking project. ♦ Target sources. Internal and exter-nal benchmark sources exist. Internalbenchmarking involves comparingareas that perform similar work andmay exemplify best practices withinthe organization. Moreover, theseenable you to compare current prac-tice to previous performance.Internal benchmarking may involvemedical units, providers, suppliers,and payers. It’s the most simple and,generally, the least expensivemethod. It’s also easier to incorpo-rate best internal practices within anorganization’s departments and ser-vices rather than incorporate thosefrom external organizations with dif-ferent cultures and policies.14

External benchmarking refines whatorganizations know about their ownprocesses and promotes out-of-the-box thinking. Take advantage of anyacademic affiliation with universitylibraries and other resources. Publicdata is also available from industryand professional societies, state orga-nizations, the Centers for Medicare& Medicaid Services, the JointCommission on Accreditation ofHealthcare Organizations, hospitalcorporations and consortia (e.g., theSunHealth Alliance, VoluntaryHospitals of America, UniversityHealthSystem Consortium), or fromhealth care data-management com-

www.nursingmanagement.com January 2003 Nursing Management 21

Tips for successful benchmarking♦ Don’t confuse benchmarking with market research. Benchmarking surveystell where one organization ranks against others, but that, in itself, won’timprove that organization’s position.1♦ Align your benchmarking goals with your organization’s strategy and mission. ♦ Avoid processes that are too large, intangible, or complex to bemanageable. ♦ Use a balanced scorecard when developing benchmarking measures. Don’tfocus too much on cost cutting at the expense of patient satisfaction. ♦ Ensure that your benchmarking team represents key process stakeholders.♦ Verify that project participants know the benchmarking process or receive pro p e rtraining. ♦ Understand the value of careful planning to avoid redoing work or wastedefforts.2♦ Establish a baseline. It’s difficult to redesign a process that doesn’t exist.3♦ Encourage active participation from individuals at all organization levels.♦ Learn not only from the best practices of external benchmarking partners,but also from their failed experiences in remedying the same process.4♦ Be creative with your benchmarking and explore other industries forperformance excellence.5♦ Choose words carefully when communicating. For example, replace “produc-tivity” with “continuous improvement.”6

♦ Maintain ongoing relationships with benchmarking partners.

References1. M a h o n e y, C.: “Benchmarking Your Way to Smarter Decisions,” Wo r k f o rc e. 79(10):100-104,

2 0 0 0 .2. Lenz, S., et al.: “Benchmarking: Finding Ways to Improve,” Journal on Quality

Improvement. 20(5):266, 1994.3. Campbell, B.: “Benchmarking: A Performance Intervention,” Journal on Quality

Improvement. 20(5):225-237, 1994.4. Lewis, A., White, J., and Davis, B.: “Appointment Access: Planning to Benchmark a

Complex Issue,” Journal on Quality Improvement. 20(5):285-293, 1994.5. Iacobucci, D., and Nordhielm, C.: “Creative Benchmarking,” Harvard Business

Review. 78(6): 24-26, 2000.6. Campbell, B.: loc cit.

panies such as the Association forBenchmarking Health Care.

Attaining benchmarking datafrom peer hospitals requires moreinsight and networking from theexecutive team. Since medical prac-tices and markets vary by region,select benchmarking partners basedon those that are similar in size, rep-utation, city size, unionization, andteaching affiliation. Choose regionalhospitals to compare the operationsand costs of hospitals competing forthe same patients.15 Also considerusing consultants to help identifythe most appropriate hospitals tobenchmark against. Ultimately,internal and external benchmarkingis only as good as the accuracy ofreporting and the willingness toshare this data amongorganizations.16

2. Benchmarking analysis:♦ Collect data. Once you’ve identi-fied benchmarking sources, developyour methodology and data collec-tion instruments. The ease of thisdepends on whether the data isalready in a usable format and isroutinely generated from hospitalreports. Examples of data includesupply use, patient charges, wageand labor statistics, and qualityimprovement measures. Other typesof data can be collected only byobservation. This is true for process-oriented services that are time sensi-tive, such as patient admissions,transfers, and discharges. Be awarethat this step may be time-consum-ing if the organization works withinformation systems, reviews manu-ally kept records, or interviews ortracks data that’s incomplete.17

♦ Translate data. Use this step toestablish an “apples to apples” com-parison. Translate data from multi-ple sources into a common format,which will require a well under-stood, detailed definition of indica-tors. For example, how’s the operat-

ing room starting time defined? Is itbefore or after the patient has beenprepped? If you’re evaluating pay-roll statistics, ensure that the data isconsistent in the inclusion and exclu-sion of fringe benefits and wage ratedifferences.18

♦ Categorize achievement levels.Once you’ve placed the data into acomparable format, categorize itaccording to level of achievement toestablish profiles for your own orga-nization and benchmarks. For exam-ple, on the basis of cost, the team canoutline its own organization in com-parison to the top performing bench-marked organizations, as expressedfrom the lowest to the highest costcomponents.19

♦ Understand performance gaps.Understanding the factors that drivethe diff e rences between the org a n i z a-tion and the benchmarks is key todeciding what steps will follow. Whatopportunities are there for impro v e dp rocess flow? It’s important to pinpointthe reasons for these performance gaps.

Examples may include role confusion,miscommunication, unrealistic expecta-tions, inadequate training, outmodedtechnology/facility design,supplier/payer responsiveness, oru n s t ru c t u red performancere v i e w / p rocess feedback. Your pro j e c tteam should categorize these diff e r-ences into those that can be modifiedand implemented and those that eithercan’t be changed or have to be workeda ro u n d .2 0

♦ Verify results. Verify results from thee n t i re benchmarking process to ensurea c c u r a c y. To do so, review data andconclusions with experts in the org a n i-zation who’ve worked closely with thep rocess. It’s important that everydepartment/service impacted by thisp rocess be re p resented during thise v a l u a t i o n .♦ Present conclusions, create actions t e p s. Your presentation should beobjective, factual, simple, and straight-f o r w a rd. Charts and graphs facilitatevisualization. Once presented, yourp roject’s conclusions will be challengedand a plan of action will be off e re d .This may be fairly clear if the appro p r i-ate benchmarks selected already off e rsolutions or improvement opportuni-ties. However, each organization shouldconsider multiple factors when decid-ing what steps to take, such as the insti-tution’s vision, mission, culture, patientpopulation, and re s o u rce limitations.♦ Create a taskforce for implemen-tation, maintenance. Your executiveteam will most likely make the finaldecision in selecting what steps totake from the benchmarking projectand the task force committee usedfor implementation. This task forceshould represent stakeholdersinvolved in the process who arecommitted to the implementationgoals. The success of this group willdetermine the overall impact thisbenchmarking project makes on theorganization. Members need todevote time, effort, and expertise,

www.nursingmanagement.com22 Nursing Management January 2003

B e n c h m a r k i n g

Review data andconclusions with

experts in theorganization who’veworked closely with

the process.

and offer visible leadership andteam management. The task forceshould be prepared to deal with anystaff resistance to change.

Stepping up, standing outIncorporate benchmarking into yourorganization’s culture while promot-ing nursing visibility and high quali-ty care. For example, use cost datafrom benchmarking to justifystaffing patterns. In addition torecruitment and retention, exploreother nursing-related targets such as:productivity (staffing ratios, budgetforecasting, personnel costs), clinicalissues (protocols, patient manage-ment, reduction in hospital-acquiredinfections), operational issues (timecycles, triage, registration, dischargeprocess, supply costs, inventoryturns), and patient satisfaction.

The benchmarking processshouldn’t end with one project;maintain and promote it continuous-ly throughout your organization toincrease leverage. You play a keyrole in providing innovative uses for

benchmark data and taking owner-ship of benchmarking projects thatwill help your hospital rise abovecompetitors through improvedpatient outcomes. Encourage nursesat all levels to participate in bench-marking initiatives. By identifyingand establishing attainable perfor-mance goals, you and your staff willelevate your organization to a bestpractice facility.

References1. Evans, A.: Avoid These Ten Benchmarking

M i s t a k e s. Available on-line: http://www.b e n c h m a r k i n g p l u s . c o m . a u / m i s t a k e s . h t m .

2. Ibid.3. B y rne, J., Schre i n e r, S., Rizk, E., and

Sokolowski, L.: “Clinical QualityBenchmarking: Here’s How to Do It–andW h y,” Tru s t e e . 51(5): B1-B4, 1998.

4. Campbell, B.: “Benchmarking: APerformance Intervention,” Journal onQuality Improvement. 20(5):225-237 ,1994.

5. American College of Emergency Medicine:Benchmarking in Emergency Medicine.Available on-line: http://www. a c e p .o rg / 1 , 4 7 1 7 , 0 . h t m l .

6. Lenz, S., et al.: “Benchmarking: FindingWays to Improve,” Journal on QualityImprovement. 20(5): 266, 1994.

7. American College of EmergencyMedicine: loc cit.

8. Mosel, D., and Gift, B.: “CollaborativeBenchmarking in Health Care,” Journalon Quality Improvement. 20(5): 241,1994.

9. Lenz, S., et al.: loc cit.10. Byrne, J., Schreiner, S., Rizk, E., and

Sokolowski, L.: loc cit.11. Berkey, T.: “Benchmarking in Health

Care: Turning Challenges into Success,”Journal on Quality Improvement.20(5):277-283, 1994.

12. Lenz, S., et al.: loc cit.13. Ibid.14. Ibid.15. Ibid.16. Williams, M.: “Benchmarking to Improve

Financial Performance,” HealthManagement Technology. 16(2):10-12,1995.

17. Rudy, E., Lucke, J., Whitman, G., andDavidson, L.: “Benchmarking PatientOutcomes,” Journal of NursingScholarship. 33(2):185-189, 2001.

18. Lenz, S., et al.: loc cit.19. Ibid.20. Ibid.

About the authorMy N. Tran is an RN in the IntermediateCoronary Care Unit of Virginia HospitalCenter, Falls Church, Va.

www.nursingmanagement.com January 2003 Nursing Management 23

TO EARN CE CREDIT, FOLLOW THESE INSTRUCTIONS:1 . Choose one answer for each question and darken box.2 . Fill in registration information and evaluation on answer form

(Social Security or nursing license number must be included toprocess test).

3 . Mail your answer form (copies accepted) and $12.95 process-ing fee to: Lippincott Williams & Wilkins, 2710 YorktowneBlvd., Brick, NJ 08723. Make checks payable to LippincottWilliams & Wilkins; if paying by credit card, include number andexpiration date. Within 4 weeks, you’ll be notified of your testresults.

4 . New discount pro c e d u re : Take 75¢ off the price of each test ifsubmitting two or more tests at a time from any issue.

5 . Fax-back serv i c e : Fax your test (credit card orders only) to732-255-2926 and we’ll fax back your CE certificate within 2business days. Provide a fax number for a location where con-fidential information will be safe (home/workplace). Faxes sentto a workplace will be accompanied by a cover letter. Wearen’t responsible for faxes not received due to malfunctioningmachine on receiving end. A CE certificate will be mailed afterattempts to fax have failed.

6 . Take tests on-line at http://www.nursingcenter.com/prodev/ce_online.asp and have them processed immediately.

The passing score for tests is 70%. If you pass, a certificate for earned con-

tact hours will be awarded by Lippincott Williams & Wilkins. You’ll alsoreceive an answer sheet with the rationale for each correct answer. If you failthe test, you can take the test again for free. For questions about testresults, contact Lippincott Williams & Wilkins, Springhouse Office, CED e p t ., 1111 Bethlehem Pike, P.O. Box 908, Springhouse, PA 19477;1 - 8 0 0 - 3 4 6 -7844, ext. 6513.

PROVIDER INFORMATION:This continuing nursing education (CNE) activity for 1.5 con-tact hours is provided by Lippincott Williams & Wilkins, whichis accredited as a provider of continuing education in nursingby the American Nurses Credentialing Center’s Commission onAccreditation and by the American Association of Critical-CareNurses (AACN 9722; category O). This activity is alsoprovider-approved by the California Board of RegisteredNursing, provider #CEP11749, for 1.5 contact hours.Lippincott Williams & Wilkins is also an approved provider ofCNE in Alabama (#ABNP0114), Florida (#FBN2454), and Iowa(#75).* All of its home study activities are classified for Texasnursing continuing education requirements as Type I. Your cer-tificate is valid in all states.

*In accordance with Iowa Board of Nursing administrative rulesgoverning grievances, a copy of your evaluation of this CE

Take the test on page 24—and earn CE cre d i t .

Earn 1.5 contact hours for the Take Benchmarking to the Next Level test.

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TAKE BENCHMARKING TO THE NEXT LEVELAnswer Form

B e f o re December 31, 2004, cut out or copy this form andmail or fax to: Lippincott Williams & Wilkins, 2710 Yo r k t o w n eBlvd., Brick, NJ 08723, fax number 732-255-2926, phonenumber 1-800-346-7844, ext. 6513. Mail your test with acheck for $12.95 (1st test) payable in U.S. funds only, toLippincott Williams & Wilkins, or include your credit cardi n f o rmation. Take 75¢ off every test if submitting two orm o re tests at a time. These prices do not pertain to the

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D i s a g re e A g re e1. I met objective 1. 1 2 3 42. I met objective 2. 1 2 3 43. I met objective 3. 1 2 3 44. The objectives related to the overall purpose of the activity. 1 2 3 45. The learning method was effective for me. 1 2 3 46. It took______(hrs.) _______(mins.) to read and review the ar ticle and take the test.Any licensed nurse may submit this evaluation form directly to the Iowa Board of Nursing.

1. 2. 3. 4. 5. 6. 7. 8. 9.■ 1. ■ 1. ■ 1. ■ 1. ■ 1. ■ 1. ■ 1. ■ 1. ■ 1.■ 2. ■ 2. ■ 2. ■ 2. ■ 2. ■ 2. ■ 2. ■ 2. ■ 2.■ 3. ■ 3. ■ 3. ■ 3. ■ 3. ■ 3. ■ 3. ■ 3. ■ 3.■ 4. ■ 4. ■ 4. ■ 4. ■ 4. ■ 4. ■ 4. ■ 4. ■ 4.

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CE

1.5ANCC/AACN CONTACT HOURS

TAKE BENCHMARKING TO THE NEXT LEVELP u r p o s e : To improve nursing practice and the quality of care by providing a learning opportunity that enhances a participant’s understanding of benchmarking.PA RT I C I PANT OBJECTIVES: After reading the article and taking this test, you should be able to: 1 . Identify the goals of benchmarking. 2 . Describe the pre p a r a t i o nphase of the benchmarking process. 3 . Describe the steps involved in benchmarking analysis.

M013

1. Benchmarking is1. rarely confused with market re s e a rc h .2. simply comparing one hospital to another.3. measuring the perf o rmance of a future pro c e s s .4. targeting improvement eff o rts that eventuallyyield best practices.

2. Which is correct about benchmarking?1. Hospitals originally used external approaches toi m p rove perf o rm a n c e .2. “Trust” in health care delivery has replaced high-quality data.3. An organization risks losing patients if it can’tdemonstrate its own quality care measure s .4. Benchmarking is an uncommon business practicefor forw a rd-thinking health care org a n i z a t i o n s .

3. Problem-based benchmarking1. targets eff o rts at specific concern s .2. involves a process-oriented appro a c h .3. is the current focus of the quality impro v e m e n tmovement in health care .4. entails targeting continuous improvement of keyp ro c e s s e s .

4. Which benchmarking function involves strivingto become the new benchmark?1. analysis of the operation2. knowledge of competition and industry leaders3. incorporation of the “best of the best”4. established superiority

5. Knowledge of competition and industry leadersi n v o l v e s1. assessing strengths and weaknesses of curre n twork pro c e s s e s .2. finding out who’s the “best of the best.”3. analyzing critical cost components.4. considering customer complaints.

6. Which is correct about the actual benchmark-ing pro c e s s ?1. Few benchmarking processes are available.2. A wide variety of processes are tailored to thehealth care industry.3. Early initiatives were led by small health careo rg a n i z a t i o n s .4. The process adapted from the BaxterBenchmarking Model is divided into four part s .

7. The preparation phase of benchmarking includes1. collecting data.2. categorizing achievement levels.

3. establishing measure s .4. understanding perf o rmance gaps.

8. Which statement best describes goal selectionin the preparation phase of benchmarking?1. A team of executives is used to define goals.2. Organizational top leadership must supportbenchmarking eff o rts for success.3. The main objective is finding the lowest cost.4. Financial measures are given priority consideration.

9. Which statement best describes process defini-tion in the benchmarking preparation phase?1. Quality improvement tools such as cause-and-e ffect diagrams aren’t generally useful.2. Revisions are made to the current process priorto establishing an outline.3. Policies and pro c e d u res, as well as critical path-ways, tend to prevent dialog.4. Staff members working closely with the pro c e s sa re involved because they’ll most likely be involvedin future implementation eff o rt s .

10. A component of the benchmarking analysisphase includes1. identifying re s o u rc e s .2. translating data.3. setting timeframes.4. defining pro c e s s e s .

11. Time cycles, costs, lengths of stay, staff i n gratios, satisfaction rates, and erro r / c o m p l i a n c erates are examples of1. indicators to measure perf o rmance analysis.2. identifiable re s o u rc e s .3. benchmarking sourc e s .4. data translation.

12. Internal benchmarking1. involves comparing areas that perf o rm similar work.2. refines the organization’s knowledge of it’s ownp ro c e s s e s .3. takes advantage of re s o u rces such as academica ffiliation with university libraries.4. utilizes public data available from industry andp rofessional societies.

13. External benchmarking1. may involve medical units, providers, suppliers,and payers.2. enables comparison of current practice to pre v i-ous perf o rm a n c e .3. promotes out-of-the-box thinking.

4. may exemplify best practices within the org a n i z a t i o n .

14. Data generated from time sensitive pro c e s s -oriented services include1. patient charg e s .2. admissions and transfers are a s .3. wage and labor statistics.4. quality improvement measure s .

15. Which benchmarking step establishes an“apples to apples” comparison?1. collecting data2. categorizing achievement levels3. translating data4. verifying re s u l t s

16. Possible explanations for perf o rmance gapsi n c l u d e1. time cycles.2. role confusion.3. lengths of stay.4. patient satisfaction rates.

17. The presentation of benchmarking conclusionsshould be1. subjective.2. complex.3. devoid of charts and graphs.4. factual and straightforw a rd .

18. The final decision in selecting the steps totake from the benchmarking project will most like-ly be made by members of (the)1. taskforce committee.2. project team.3. nursing management.4. executive team.

19. When attaining benchmarking data fro manother hospital, choose one that1. is larger in size.2. has a diff e rent re p u t a t i o n .3. is located in a diff e rent sized city.4. has a similar teaching aff i l i a t i o n .

20. Which of the following best describes suc-cessful benchmarking?1. Benchmarking is comparable to survey part i c i p a t i o n .2. Processes should be intangible and complex.3. Wo rds such as “productivity” should be re p l a c e dwith “continuous impro v e m e n t . ”4. Goals should be aligned with the org a n i z a t i o n ’ sstrategy and mission.