Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109, Australia.
Australian Centre for Precision Health, Cancer Research Institute (UniSA CRI), School of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia.
Int J Qual Health Care. 2020 Feb 6;32(Supplement_1):84-88. doi: 10.1093/intqhc/mzz109.
This paper examines the principles of benchmarking in healthcare and how benchmarking can contribute to practice improvement and improved health outcomes for patients. It uses the Deepening our Understanding of Quality in Australia (DUQuA) study published in this Supplement and DUQuA's predecessor in Europe, the Deepening our Understanding of Quality improvement in Europe (DUQuE) study, as models. Benchmarking is where the performances of institutions or individuals are compared using agreed indicators or standards. The rationale for benchmarking is that institutions will respond positively to being identified as a low outlier or desire to be or stay as a high performer, or both, and patients will be empowered to make choices to seek care at institutions that are high performers. Benchmarking often begins with a conceptual framework that is based on a logic model. Such a framework can drive the selection of indicators to measure performance, rather than their selection being based on what is easy to measure. A Donabedian range of indicators can be chosen, including structure, process and outcomes, created around multiple domains or specialties. Indicators based on continuous variables allow organizations to understand where their performance is within a population, and their interdependencies and associations can be understood. Benchmarking should optimally target providers, in order to drive them towards improvement. The DUQuA and DUQuE studies both incorporated some of these principles into their design, thereby creating a model of how to incorporate robust benchmarking into large-scale health services research.
本文探讨了医疗保健中基准测试的原则，以及基准测试如何有助于实践改进和改善患者的健康结果。它使用了在本增刊中发表的澳大利亚深化质量理解（DUQuA）研究和欧洲的 DUQuA 前身深化质量改进在欧洲的理解（DUQuE）研究作为模型。基准测试是使用商定的指标或标准比较机构或个人绩效的方法。基准测试的基本原理是，机构将对被确定为低异常值或渴望成为或保持高绩效者的机构做出积极反应，或者两者兼而有之，并且患者将有权选择在高绩效机构接受护理。基准测试通常始于基于逻辑模型的概念框架。这样的框架可以驱动选择用于衡量绩效的指标，而不是基于易于衡量的指标来选择。可以选择一系列 Donabedian 指标，包括围绕多个领域或专业创建的结构、过程和结果。基于连续变量的指标可以使组织了解其在人群中的绩效水平，并且可以理解它们的相互依存关系和关联。基准测试应将重点放在供应商上，以推动他们进行改进。DUQuA 和 DUQuE 研究都将其中一些原则纳入其设计，从而为如何将强大的基准测试纳入大规模卫生服务研究创建了一个模型。
