NPQR Laboratory Performance Benchmarking

By Ali Brown, MD, FASCP - August 31, 2021

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Benchmarking is commonly employed in healthcare and other industries to compare an organization’s performance with an external standard. Ideally, benchmarks compare performance metrics to those of similar organizations to identify areas where they are performing well in addition to identifying opportunities ripe for improvement initiatives.

There are multiple benchmarking strategies that are used by healthcare organizations. Internal benchmarking compares functions within an organization, for example, hand hygiene practices in different hospital units or lab test utilization between departments. Competitive benchmarking compares an organization’s process to another’s process or similar service. You have probably seen public-facing monitors of emergency department wait times in your community, and may be familiar with lab-related examples such as test result turnaround times and subspecialty expertise. On a larger scale, functional benchmarking compares performance across industries, such as customer/patient experience, and “employers of choice” programs.


The origins of pathology benchmarking

Benchmarking in pathology began in 1947 with an abstract presented at the 26th annual ASCP meeting in Chicago, subsequently published in the American Journal of Clinical Pathology. This study, “A Survey of the Accuracy of Chemical Analyses in Clinical Laboratories” by Belk and Sunderman of the Medical Society of the State of Pennsylvania, determined there was significant variation in results for various chemistry analytes between laboratories in their region. Now, with NPQR, ASCP is taking benchmarking into the 21st century with data analytics coupled with quality improvement education.

With real-time analytics, benchmarking enables practices to track improvements over time. A tool like the NPQR provides timely data that can be used to identify and prioritize improvement goals and track progress toward these goals. Once improvements have been implemented, benchmarking can be used to monitor the maintenance of changes that were made to assess performance long-term and compliance to protocols.

On an individual level, benchmarking can create buy-in for performance improvement teams, and can be an effective step toward building a culture of quality. Offering transparency of data while steering clear of punitive messaging allows team members to reflect more effectively on their own performance and to understand where their opportunities are in comparison to others. The goal is to aim beyond the benchmark, to be best in class.

There is a wide range of performance data elements that can be benchmarked in the laboratory. Turnaround times, volumes and preanalytical errors are metrics that span both anatomic and clinical pathology. Tracking and targeting improvements in these areas can have a significant impact on quality, and can be applied broadly to the entire laboratory or to targeted sections that are in need of resources. Test utilization, another area that is commonly in need of laboratory guidance, can be assessed, tracked over time, and examined at the department, individual test, or ordering provider level. Collecting data on laboratory-led utilization efforts provides pathologists with a powerful tool to demonstrate their teams’ impact on patient care and cost.

Outside of the laboratory, hospital executives are used to looking at benchmark data in order to make decisions regarding resource allocation, so it is useful to have reliable data to present to leadership both within the lab and at the C-suite level. While benchmarking can be a heavy resource burden, the NPQR provides data obtained from a laboratory’s LIS and quality records to create interactive dashboards that are compared to peer data sets. These analytics are performed behind the scenes with minimal ongoing technical resources required from the participating lab. Pairing these data analytics with ASCP’s quality improvement education resources creates an incredibly powerful tool for performance improvement and enhanced patient care.

Ali Brown, MD, FASCP

Chief Officer, Medical Quality