It is a widely held belief among health care leaders that comparing their hospitals and clinics t peers is very important. Benchmarking seems to assure leaders that as long as their organization’s performance is 50% of the national average or better, things are okay. But U.S. health care quality and safety is abysmal: The evidence suggests that between 240,000 to 400,000 deaths occur each year due to medical errors. Probably more go unreported. Therefore “50% or better” performance is no consolation for patients.
Leaders should count every instance of patient harm as a personal affront. A better way to focus on the right results for patients is to set targets of zero and 100% — by which I mean zero hospital-acquired infections after surgery or 100% of patients getting the right care. For example, before performing every operation the surgical team should conduct a “time-out” 100% of the time to ensure that everyone agrees that they are operating on the correct patient and are performing the correct procedure on the right site and that any questions or concerns that any team member might have are addressed. In addition, the team should follow a surgical checklist 100% of the time.
Once you know that zero is the goal, you will realize that achieving it is unlikely in your current system. If you trace every error back to its source, you will be following a trail of confusion and broken processes. Tightening that ship will not get you to zero. Radical redesign of care-delivery processes is the only way to change an organization’s expectations.