How can we use the metrics typically reported in perioperative benchmarks? 

Although comparing the performance of your hospital to another through benchmarks is not always as helpful as we often think, you can still glean an enormous amount of value by studying those metrics carefully. Here we will focus on the perioperative area of a hospital.

Each perioperative team at any given moment in time is unique. The population being served, the teams that contributed, and the healthcare system’s aspiration and strategy may all differ from one another. Here is what each perioperative leadership team could do with the metrics they gather for reporting purposes: 

1. Develop your own organization’s vision: If you were to describe a better future for your ORs to your customers, including patients, the physicians and staff, and other stakeholders, what would that be like? What would they feel, and what would they say? Among all the great things you have in your vision, which are more important than others? What system objectives and challenges would you take into account? Start with these qualitative assessments and define what kind of outcome and goals your stakeholders most care about to craft a cohesive strategy and clear focus. 
2. Make the vision concrete with clear key results and metrics: Once there’s an  aligned vision and priority, it will become much clearer which metric to look into. For instance, if you were to focus on improving the experience of patients, you may need to measure how long patients are forced to wait, or how often they wait longer than an acceptable threshold of time. With this insight you would discern that turnover time may be a contributing factor because it is resulting in a weak aspect of the patient experience you think should be improved. 

Once you dig further, however, you may realize the correlation between the turnover time and the wait time experienced by patients is in fact not consistent. There may be several occasions when turnover time was high, but the patient did not actually experience the wait because they were undergoing some pre-operative work. On other occasions, even with a rapid turnover, the patient may have been forced to wait. It is possible that a  stronger metric is to calculate a version of the time difference between when the patient was scheduled to go in an OR vs. when they were actually wheeled in. 

Similarly, if you are focused on improving patient access to the OR, you could analyze the gap between the day a surgery was scheduled and when it was actually performed. You might also analyze prime time utilization and/or the number of cases per day per room as a proxy for the capacity of the OR that would essentially provide more access to patients. 

Aspire for continued improvement

Now that your team is equipped with an aspiring vision, a clear focus, and concrete metrics to improve, targets for those metrics are needed to make the goals measurable. Then as the team establishes a cohesive narrative, any measurable improvement can be tied back to the progress of realizing the vision. If the metric of number of patients who experienced an excessive amount of time waiting is reduced by 30%, the team knows that they delivered a better experience to 30% of their patients. The impact of the achievement is obvious for everyone on the team. 

Overall, when dealing with benchmarks as a healthcare organization, the key objective is to compete with oneself and get better over time. Competing with other entities assuming that the metrics have been correctly “normalized” is misleading. At the end of day, it doesn’t matter if you’re doing better or worse on turnover or any other metric compared to others – it’s unclear who would care and to what extent. It only matters if you are making a real impact that moves the needle, on the patients and other stakeholders about whom you care the most.