Benchmarking

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Chapter: Hospital pharmacy : Managing services

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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