The Role of Benchmarking
Benchmarking compares an organization's performance metrics against internal historical performance, industry standards, or peer organizations to identify improvement opportunities. RHIA candidates should understand both internal and external benchmarking approaches and how HIM departments apply them to operational metrics.
Types of Benchmarks
- Internal benchmarking: comparing current performance to the organization's own historical data, such as tracking discharged not final billed days month over month.
- Competitive or external benchmarking: comparing performance against similar organizations, often through vendor supplied or association supplied comparative data sets.
- Best practice benchmarking: identifying and adopting practices from top performing organizations regardless of industry similarity.
Common HIM Metrics
- Coding productivity, typically measured in charts coded per hour.
- Coding accuracy rate, measured through internal or external quality audits.
- Discharged not final billed, tracking the volume and age of accounts pending coding completion.
- Release of information turnaround time.
- Physician query response rate and query agreement rate.
Building a Performance Dashboard
An effective dashboard presents key metrics visually, often using trend lines and threshold indicators, allowing managers to quickly identify metrics falling outside acceptable ranges. Dashboards should balance leading indicators, which predict future performance such as query volume, with lagging indicators, which reflect completed outcomes such as final coding accuracy.
Statistical Process Control
Some HIM departments apply statistical process control techniques, using control charts to distinguish normal variation from a true special cause requiring intervention. Understanding the difference between common cause variation, which is inherent to the process, and special cause variation, which signals a specific problem, helps prevent overreacting to normal fluctuation.
Using Benchmarks for Improvement
Benchmarking data should feed directly into performance improvement initiatives, often structured using a plan-do-study-act cycle, where a benchmark gap identifies the target, a change is tested on a small scale, results are studied, and successful changes are adopted more broadly.
Exam Tip
Distinguish benchmarking, which is comparative, from simple trend monitoring, which only examines an organization's own data over time without external comparison. Exam questions sometimes test this distinction directly.