The primary aim of a benchmarking exercise is to use and collect data to provide quantitative and, preferably, qualitative means of measuring per-formance through the production of a range of indicators, which can be compared with other similar organisations.
Benchmarking
Managers working at
all levels of the organisation have an obligation to ensure that their services
are continually reviewed and adapted to meet the changing needs of patients and
staff. In the current NHS climate where productivity and efficiency need to be
maximised, benchmarking has become increasingly recognised as a valuable
management tool for assessing the per-formance of a service and identifying
opportunities for developing better services and using staff more effectively
and efficiently. An important feature of benchmarking is the comparison with
other similar-sized hospitals or services, as this allows managers to consider
alternative ways of planning and delivering their services based on the wider
experience of others.
The primary aim of a
benchmarking exercise is to use and collect data to provide quantitative and,
preferably, qualitative means of measuring per-formance through the production
of a range of indicators, which can be compared with other similar
organisations. Benchmarks for pharmacy are produced by combining, for example,
clinical activity, workload data and staffing information to produce indicators
such as the number of staff per 1000 inpatient bed days or 1000 outpatient
attendances. These indicators can then be used both to compare different
hospitals and to produce annual trend data for an individual hospital.
As previously
described, the hospital pharmacy service is characterised by the number of
posts in the staffing establishment, measured as WTEs. The establishment will
comprise professional, technical, administrative and clerical staff, as well as
pharmacist and technician trainees. The numbers, grades and types of staff
employed are commonly referred to as the skill mix. The process of reviewing
the composition and size of the staffing establishment is known as workforce
planning. The aim should be to achieve a staffing estab-lishment and skill mix
in the department that suit the size, complexity and clinical activity of the
hospital and the demands and workloads placed on the pharmacy service;
benchmarking information is a useful tool to support this.
Local intelligence
must be used when reviewing all benchmarking data, as it is important to ensure
similar services are being compared. Ideally, bench-marks should be
sufficiently sensitive to demonstrate whether gaps in service provision may lead
to less effective medicines management and increased risk for patients, but
often quantitative data will not on their own be able to provide this level of
sophistication. For example, the quantitative data may show that one service
runs with half of the staffing costs of its neighbouring hospital but it may be
that the more expensive trust provides services under service level agreements
to other organisations or that the lack of trained, experienced clinical
pharmacists in the ‘more efficient’ organisation may reduce the quality of
prescription intervention monitoring, provide insuffi-cient prescribing support
for the junior doctors and reduce the ability to implement the formulary and
thus contain medicine expenditure. Similarly, within the pharmacy department,
an inadequate staffing establishment required to manage dispensing workloads
may cause increased error rates. It is important to remember when interpreting
benchmarking information that the natural position for any staff member to take
is that the information provided is inaccurate or inappropriate and to defend
the existing staffing or service position. However, chief pharmacists and other
pharmacy team leaders must look at information gathered and review comparisons
with an open mind to ensure efficiency opportunities are not overlooked.
Involving team members in the data collection can help to support the
robustness and acceptability of data used to provide benchmarking information.
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