University of Twente Student Theses


Benchmarking the efficiency of the process of colorectal surgery in Dutch hospitals

Niezink, Anne (2011) Benchmarking the efficiency of the process of colorectal surgery in Dutch hospitals.

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Abstract:Background Quality of health care has become an important issue in the last decades. Continuous Quality Improvement is an approach to improve the process (efficiency, effectiveness and timeliness of health care) directly, which is related to patient related outcomes (patient centeredness and safety of health care) indirectly. One of the tools to stimulate Continuous Quality Improvement is benchmarking. Research questions This first research question focuses on the exploration of the relation between efficiency (lead times, number of patient visits and costs) and patient related outcomes (process and outcome indicators) in colorectal cancer. The second research question searches an answer on the question ‘how should data be presented in a benchmark report to Dutch medical specialists participating in the colorectal process?’. Method Eight hospitals were visited, during three or four days, and data about efficiency and patient related outcomes were collected, related to care for patients with colorectal carcinoma. Chi-square tests and one-way ANOVA tests were used to analyze the data. Combining the data, a first attempt was made to define the most efficient pathway. Besides, the data collected were also used to propose a benchmark format. This was done after answering the second research question performing a literature review, comparing national and international benchmark reports and asking expert advice. Results A lot of relations were found after the analysis. Some relations were very relevant, most notable are the positive relation found between the waiting time before surgery and the number of complication after surgery and the negative relation between the length of the operation and preoperative imaging. No answer to the second research question could be given based on the literature, most literature focused on the effects of benchmarking and feedback on outcomes. Taking the advice of the experts in account a benchmark format was proposed. Important success factors for a good benchmark are that it is continuous, that the data are easy to interpret, and that clear suggestions are made for improvement, to stimulate improvement a list of best practices could be presented. Conclusion A relation between efficiency variables and patient related outcomes was found, further research is however needed to further analyze the data and to find an explanation for this relation. In the future it could be possible to settle efficiency goals and to stimulate improvement by identifying and learning from best practices.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
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