Improving surgical outcomes through benchmarking.

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.