Does physician benchmarking improve performance of laparoscopically assisted vaginal hysterectomy?
BACKGROUND
Benchmarking techniques were implemented to optimize operating time and charges associated with laparoscopically assisted vaginal hysterectomy (LAVH).


METHODS
The baseline LAVH profile over a period of 4 years (167 cases) was compared with 1-year data (47 cases) after a benchmarking educational program (disseminating data ranking performance by each surgeon plus suggestions for improvement). Preintervention and postintervention profiles were compared by means of Student t test and wilcoxon rank sum analysis. Hierarchical multiple regression was used to identify additional sources of variation for operative charges and time.


RESULTS
Mean operating times after implementing benchmarking were lower, averaging 182 versus 197 minutes in the control subjects (P = 0.05). We found no significant difference in total or operative charges. After adjusting for potential confounders, benchmarking remained associated with decreased operating time in the multivariate model (P = 0.01).


CONCLUSIONS
LAVH operating times decreased after a surgical benchmarking and education intervention, but operating charges did not.
Tu
Frank F
FF
Department of Obstetrics and Gynecology, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. ftu@enh.org
Feinglass
Joe
J
Milad
Magdy P
MP
D019985:Benchmarking; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000191:economics / Q000379:methods / Q000592:standards*; D007087:Illinois; D010535:Laparoscopy / Q000191:economics / Q000592:standards*; D008875:Middle Aged; D009929:Organ Size; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D013997:Time Factors; D014599:Uterus / Q000473:pathology