title: International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.
abstract: BACKGROUND
  Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres.
  
  
  METHODS
  Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives.
  
  
  RESULTS
  We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found.
  
  
  CONCLUSIONS
  The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.
authors.affiliation: Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, PO Box 902031006, BE Amsterdam, The Netherlands. w.v.lent@nki.nl
authors.forename: Wineke A M
authors.initials: WA
authors.lastname: van Lent
authors.forename: Relinde D
authors.initials: RD
authors.lastname: de Beer
authors.forename: Wim H
authors.initials: WH
authors.lastname: van Harten
mesh_terms: D000553:Ambulatory Care / Q000592:standards / Q000639:trends; D019985:Benchmarking / Q000379:methods*; D002173:Cancer Care Facilities / Q000592:standards*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003191:Comprehensive Health Care / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007391:International Cooperation; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D009426:Netherlands; D016522:Oncology Service, Hospital / Q000592:standards; D017063:Outcome Assessment, Health Care; D019984:Quality Indicators, Health Care; D018714:Radiotherapy, Adjuvant
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