title: Benchmarking in pathology:  development of a benchmarking complexity unit and associated key performance indicators.
abstract: This paper details the development of a new type of pathology laboratory productivity unit, the benchmarking complexity unit (BCU). The BCU provides a comparative index of laboratory efficiency, regardless of test mix. It also enables estimation of a measure of how much complex pathology a laboratory performs, and the identification of peer organisations for the purposes of comparison and benchmarking.
  
  
  
  The BCU is based on the theory that wage rates reflect productivity at the margin. A weighting factor for the ratio of medical to technical staff time was dynamically calculated based on actual participant site data. Given this weighting, a complexity value for each test, at each site, was calculated. The median complexity value (number of BCUs) for that test across all participating sites was taken as its complexity value for the Benchmarking in Pathology Program.
  
  
  
  The BCU allowed implementation of an unbiased comparison unit and test listing that was found to be a robust indicator of the relative complexity for each test. Employing the BCU data, a number of Key Performance Indicators (KPIs) were developed, including three that address comparative organisational complexity, analytical depth and performance efficiency, respectively. Peer groups were also established using the BCU combined with simple organisational and environmental metrics.
  
  
  
  The BCU has enabled productivity statistics to be compared between organisations. The BCU corrects for differences in test mix and workload complexity of different organisations and also allows for objective stratification into peer groups.
authors.affiliation: Consultant Health Economist, Brisbane, Queensland, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Neil
authors.forename: Sally
authors.initials: S
authors.lastname: Pfeffer
authors.forename: Leslie
authors.initials: L
authors.lastname: Burnett
mesh_terms: D019985:Benchmarking / Q000191:economics / Q000379:methods / Q000592:standards*; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational / Q000191:economics / Q000592:standards*; D006801:Humans; D007753:Laboratories / Q000191:economics / Q000592:standards*; D017056:Medical Laboratory Personnel / Q000191:economics / Q000592:standards*; D010338:Pathology, Clinical / Q000191:economics / Q000592:standards*; D010379:Peer Group; D012456:Salaries and Fringe Benefits; D013647:Task Performance and Analysis; D016526:Workload