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Benchmarking: A Process for Performance Improvement &
Nursing Risk Management
Anders YUENTWGHs Fung Yiu King Hospital
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Thank You
Ms Lily CHUNGCGM(N) NTEC
Ms Betty AUCGM(N) NTWC
Ms Sandy CHANGM(N) HKBH
Ms Steve CHOWWM CCH
Ms C K KANGM(N) TWEH
Ms Kathy LEEGM(N) TWH
Ms WONG Oi-lingSNO KWH/WTSH
Ms Helena LIGM(N) OLMH
Ms Neva YUNGGM(N) HHH
Mr. Edwin TSANGNS FYKH
Mr. T K CHUNGNS SH
Ms Patricia LEENS SH
.. and many others
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Outline
1. What we have been doing in Hospital Authority?
2. At the cross-road: where to go?
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Definition of Benchmarking
An ongoing, systematic process to search for and introduce
international best practice into an organization. The search may be
for products, services or business practices and processes of
competitors or those organizations recognized as leaders in the
industry.
(MacNeil 1995)
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Why we do Benchmarking?
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Key Objectives of the Benchmarking Consortium
Where are we now?Internal communication
Professional accountabilityA tool for quality improvement &
service development? Match resources input with service
output/outcome
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Benchmarking Consortium
First established in 1998 by 8 HA hospitals onlyNow we got 13 HA
hospital members, including:
CCH SHFYK SCHHHH TPHHKBH TWEHOLMH TWHPOH WTSH
WCHH
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Our Organization Context for the Past 8 Years
Uncertainties and changesNeed time to rest and recoverEveryone
doing a few persons jobBudget is an issueStaff morale is also an
issue
. yet
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Patient Safety & Quality are still our Bottom Line
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What we have been Benchmarking since 1998?
1. Inpatient Fall Rate2. Hospital Acquired Pressure Sore Rate3.
Inpatient Unintentional Weight Loss
Rate
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Inpatient Fall Rate
Fall:Patient comes to rest unintentionally on the floor
(Morris & Isaacs, 1980)
No. of falls x 1000No. of inpatient days
(Morse, 1997)
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Average Inpatient Fall Rate in 1999: 0.78/1000 pt. day
Average Inpatient Fall Rate in 2004: 0.59/1000 pt. day
0.78
0.71
0.74
0.69 0.56 0.59
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
99 00 01 02 03 04
Year
Aver
age F
all R
ate
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Newly acquired pressure sore:Patient develop pressure sore
(Stage II or above) after 72 hours following hospital
admission.
Hospital Acquired Pressure Sore Rate
No. of new sores (Stage II or above) x 1000No. of patient
days
(ANA, 1995)
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Average Newly Acquired Pressure Sore Rate in 2000: 0.53/1000 pt.
days
Average Newly Acquired Pressure Sore Rate in 2004: 0.38/1000 pt.
days
0.380.380.340.39
0.53
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
00 01 02 03 04
Year
Aver
age P
ress
ure S
ore R
ate
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A/B x 100%
A = No. of patient with unintentional weight loss 10% in 180
days
B = No. of patient live in hospital 180 days
(RCN, 1993)
Inpatient Unintentional Weight Loss Rate
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% of Inpatient with Unintentional Weight Loss in 2001: 2.2
% of Inpatient with Unintentional Weight Loss in 2003: 2.0
2.2 2 2
0
0.5
1
1.5
2
2.5
Aver
age U
nint
entio
nal W
eight
Los
sRa
te
01 02 03
Year
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Dissemination of Results & Best Practice
7 issues of Benchmarking Bulletin have been published so
far.
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Best Practice for Fall
1. Multi-disciplinary involvement2. Awareness of Fall Prevention
by the
frontlines3. Root cause analysis for serious fall
injury
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Best Practice for Inpatient Pressure Sore Management
1. Top management concerns & support2. Sore Risk
Assessment
Reliability? Sensitivity?Time of assessment &
re-assessment
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Best Practice for Inpatient Unintentional Weight Loss
Prevention
1. Nutritional Assessment2. Early intervention for
malnourished
elderly
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Where to Go Next?
Through this joint v e n t u r e o f experience,
cont inue to other benchmarking topics, which are high patient
volume a n d h i g h r i s k .
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The Way Ahead
Task Forces for Physical Restraint ApplicationTask Force for
Urinary & Faecal Continence Care
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The Way Ahead
?Benchmarking on not only the outcomes and process, but also the
structure?Benchmarking Consortium as a formal structure of HA
