Performance indicators allow for the conversion of quality to quantifiable metrics that can provide simplified information about a larger area of interest and facilitate comparison across organizations. When benchmarking is used to this end, it includes a series of steps such as: identification of best performers through data analysis as well as in-depth (qualitative) investigation of factors that support the observed performance and quality improvement. Nowadays, benchmarking represents one of the strategies used for quality improvement, that is, «the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development». If properly used, benchmarking may also provide a mechanism to detect unwarranted variation and promote the reduction of such. The increased use of benchmarking was influenced by different factors, including the need to identify and better understand differences in healthcare practices and outcomes between and within different geographical areas. ![]() Benchmarking has become a structured method in the United States and the United Kingdom with the end goal of comparing hospital outcomes for cost-containment purposes, although comparison of outcome indicators dates back to the seventeenth century. Starting from the 1990s, benchmarking has been applied to the healthcare sector with the aim of measuring and comparing clinical outcomes across organizations as well as enabling them to learn from one another and apply best practices. Although international literature has provided several definitions and taxonomies of benchmarking, all of them share a common theme, defined as a “continuous process of measuring products, services and practices against the toughest competitors or those companies recognized as industry leaders”. Introduced in the late 70s as an effort to reduce production costs in the manufacturing sector, benchmarking has since then been used as a method for continuous quality improvement in many different sectors and fields. Although this study points towards the benefit of combining performance measurement with interventions in terms of quality, future research should further analyse the impact of these interventions individually. Furthermore, our findings indicate that benchmarking may stimulate quality improvement, and that interventions, complementary to benchmarking, seem to reinforce this improvement. The results generated from this review suggest that the practice of benchmarking in healthcare is a growing field, and more research is needed to better understand its effects on quality improvement. A combination of multiple interventions was present in over half of the studies ( N = 10). The interventions ranged from meetings between participants to quality improvement plans and financial incentives. In the majority of studies ( N = 12), at least one intervention, complementary to benchmarking, was undertaken to stimulate quality improvement. ![]() All studies reported a positive association between the use of benchmarking and quality improvement in terms of processes ( N = 10), outcomes ( N = 13) or both ( N = 7). ResultsĪ total of 17 articles were identified. Following assessment of the articles for inclusion, we conducted data analysis, quality assessment and critical synthesis according to the PRISMA guidelines for systematic literature review. We searched three databases (PubMed, Web of Science and Scopus) for articles studying the impact of benchmarking on quality of care (processes and outcomes). We also sought to provide evidence on the associated strategies that can be used to further stimulate quality improvement. As such, we conducted a systematic literature review with the aim of synthesizing the evidence regarding the relationship between benchmarking and quality improvement. Despite a growing interest in the practice and study of benchmarking, its contribution to quality of care have not been well elucidated. Benchmarking has been recognised as a valuable method to help identify strengths and weaknesses at all levels of the healthcare system.
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