title: Evaluation of an international benchmarking initiative in nine eye hospitals.
abstract: BACKGROUND
  Benchmarking has become very popular among managers to improve quality in the private and public sector, but little is known about its applicability in international hospital settings.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the applicability of an international benchmarking initiative in eye hospitals.
  
  
  METHODS
  To assess the applicability, an evaluation frame was constructed on the basis of a systematic literature review. The frame was applied longitudinally to a case study of nine eye hospitals that used a set of performance indicators for benchmarking. Document analysis, nine questionnaires, and 26 semistructured interviews with stakeholders in each hospital were used for qualitative analysis.
  
  
  RESULTS
  The evaluation frame consisted of four areas with key conditions for benchmarking: purposes of benchmarking, performance indicators, participating organizations, and performance management systems. This study showed that the international benchmarking between eye hospitals scarcely met these conditions. The used indicators were not incorporated in a performance management system in any of the hospitals. Despite the apparent homogeneity of the participants and the absence of competition, differences in ownership, governance structure, reimbursement, and market orientation made comparisons difficult. Benchmarking, however, stimulated learning and exchange of knowledge. It encouraged interaction and thereby learning on the tactical and operational levels, which is also an incentive to attract and motivate staff.
  
  
  CONCLUSIONS
  Although international hospital benchmarking seems to be a rational process of sharing performance data, this case study showed that it is highly dependent on social processes and a learning environment. It can be useful for diagnostics, helping local hospitals to catalyze performance improvements.
authors.affiliation: Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital/Institute of Health Policy and Management, Erasmus University Rotterdam, Netherlands. dekorne@oogziekenhuis.nl
authors.forename: Dirk F
authors.initials: DF
authors.lastname: de Korne
authors.forename: Kees J C A
authors.initials: KJ
authors.lastname: Sol
authors.forename: Jeroen D H
authors.initials: JD
authors.lastname: van Wijngaarden
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: van Vliet
authors.forename: Thomas
authors.initials: T
authors.lastname: Custers
authors.forename: Mark
authors.initials: M
authors.lastname: Cubbon
authors.forename: Werner
authors.initials: W
authors.lastname: Spileers
authors.forename: Jan
authors.initials: J
authors.lastname: Ygge
authors.forename: Chong-Lye
authors.initials: CL
authors.lastname: Ang
authors.forename: Niek S
authors.initials: NS
authors.lastname: Klazinga
mesh_terms: D019985:Benchmarking; D005131:Eye Injuries / Q000628:therapy*; D006782:Hospitals, Special / Q000592:standards*; D006801:Humans; D038622:Internationality; D007407:Interviews as Topic; D009885:Ophthalmology / Q000592:standards; D019982:Organizational Case Studies; D036301:Qualitative Research; D011795:Surveys and Questionnaires