Evaluation of an international benchmarking initiative in nine eye hospitals.
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.
de Korne
Dirk F
DF
Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital/Institute of Health Policy and Management, Erasmus University Rotterdam, Netherlands. dekorne@oogziekenhuis.nl
Sol
Kees J C A
KJ
van Wijngaarden
Jeroen D H
JD
van Vliet
Ellen J
EJ
Custers
Thomas
T
Cubbon
Mark
M
Spileers
Werner
W
Ygge
Jan
J
Ang
Chong-Lye
CL
Klazinga
Niek S
NS
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