A framework for benchmarking hospital performance: application to surgical site infection

Benchmarking is an approach to quality improvement where practice of leaders are studied to help improve one's own practice. Here, a framework for designing and implementing an information system for benchmarking is proposed. Participating actors are described by Structure, Process, Outcomes and indicators of case mix. The core of the information system consists in a database of actors descriptions, and in an algorithm combining rules and data on Structures, Outcomes and Case mix to identify leaders. Results from the benchmark consist in the Processes of the leaders. An example using data from a surgical site infection surveillance network is provided. Actors were hospital surgical departments. Structure consisted in the type of the hospital, specialty and annual number of interventions. The algorithm for selection of leaders was implemented using a decision tree. Using this framework, benchmarking could be facilitated and more easily accepted by professionals.