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Running head: BENCHMARKING PROJECT

Benchmarking Project

Jessica Snow

Old Dominion University

The purpose of this paper is to investigate benchmark data for three different hospitals in

the Tidewater area of Virginia. Benchmarking measures the performance of a hospital in specific

areas of care. This data is important to patients because it can help them choose the hospital that

they would like to receive care. This data is important to healthcare workers because it allows

them to see where improvements are needed.

Benchmark Data

The facilities I chose to research are Sentara Norfolk General Hospital (SNGH),

Chesapeake Regional Medical Center (CRMC), and Bon Secours Maryview Medical Center

(BSMMC). I currently work for Sentara Norfolk General Hospital and I have completed clinical

hours at the other two facilities. The specific areas researched include post-surgical infection

rates following colon surgery, patient satisfaction, emergency department wait times, and

pneumonia readmission/mortality rates.

Surgical

The first benchmark measure investigated was post-surgical infection rates following

colon surgery. SNGH rated surprisingly higher than CRMC, but lower than BSMMC (The

Leapfrog Group, 2020). However, when compared to the national average, each facility had a

lower rate of infection (Appendix B). The rating for this provides a score to each facility by

comparing the actual rate of infection and the expected rate of infection (The Leapfrog Group,

2020). This could prevent patients from going to SNGH or BSMMC for their colon surgery.
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Patient Satisfaction

For patient satisfaction, I utilized the data measure of overall patient satisfaction score (0-

10 scale) and if the patient would recommend the facility to others. 76% of patients rated SNGH

a nine or a ten and 77% would recommend SNGH to others out of 513 patients surveyed

(Medicare, 2018). Only 64% of patients rated CRMC a nine or a ten and 63% would recommend

CRMC out of 580 patients surveyed (Medicare, 2018). Even worse, BSMMC had 62% of

patients rate their care at a nine or ten and only 57% would recommend the facility out of 1023

survey participants (Medicare, 2018). Overall, SNGH was the only facility to rate above the

national percentages in these areas of focus (Appendix C).

Emergency Department Wait Times

The emergency department (ED) is the typical area that patients go to seek care. From

there, patients can be admitted to specific care units or be treated and discharged. The wait times

for both areas are measures of performance for hospitals. SNGH had the highest ED to admission

wait time at 221 minutes, BSMMC at 163 minutes, and CRMC at 77 minutes (Medicare, 2018).

SNGH did have the lowest ED to discharge from ED wait time of 133 minutes, BSMMC at 156

minutes, and CRMC the longest wait time at 193 minutes (Medicare, 2018). This may delay care

if a patient believes they will wait less time at another hospital, they could travel there instead of

waiting at their local facility. In comparison, the national average wait time for ED to admission

is 136 minutes and ED to discharge wait time is 168 minutes (Medicare, 2018). (Appendix D).

This is an area that should be improved before universal healthcare is implemented to prevent

delays in care and improve patient satisfaction.

There were two measures I focused on for pneumonia measures, readmission rate and

mortality rate. Each facility was around the national averages of 16.6 readmissions per 100,000

and 15.4 deaths per 100,000 (Hospital Care Reporting, 2016). SNGH had the lowest

readmissions but the second highest mortality of the three facilities (Appendix E). CRMC had

the lowest mortality rate but the highest readmission rate (Hospital Care Reporting, 2016).

Area for Improvement

After comparing the facilities, I was most interested in ED wait times. The wait time of

221 minutes at my workplace, SNGH, is 85 minutes longer than the national average (Medicare,

2018). When wait times are increased, delays in care occur and patients can quickly become

rightfully, dissatisfied (Shen & Lee, 2018). From this data, a plan can be made to decrease wait

times at SNGH that will ultimately increase patient satisfaction.

Plan for Improvement

Though other units need to discharge patients for ED patients to be placed, I have had

empty rooms on multiple occasions that were unable to be filled due to the ED being short

staffed. The first step in my plan is to ensure manpower is matched with patient arrivals with a

team approach. A team-based approach requires that each patient flows through a healthcare

team to ensure all steps of care are completed (Shen & Lee, 2018). With the team-based

approach, a healthcare team member can be assigned to facilitate placement for this patient if

they were to be admitted. This team member could evaluate the patient’s medical history with

their current diagnosis to figure out where the patient should be admitted. This process should

start immediately, and each team member would have a specific job. The team approach allows

for better communication among all health care staff to ultimately decrease the patient’s wait
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time (Shen & Lee, 2018). To have a functioning team, staffing would need to increase to allow

for each team member to do their specific duty.

The second step in this plan would be to provide medical doctor triaging. Currently,

SNGH triages patients by first seeing ED technicians and Registered Nurses. When medical

doctors triage and perform rapid assessments, patient flow is greatly increased because patients

that can have quick interventions can received care and be discharged (Jarvis, 2016). Most ED’s

triage patients by the critical need of care, which ignores the simpler cases and delays the care of

those patients. The patients that are delayed may experience frustration and will further require

staff assistance. This manpower could be better used elsewhere if fast interventions were made

by medical doctors through rapid assessments and immediate interventions (Jarvis, 2016).

Conclusion

Through benchmark research, I have found areas that my hospital thrives in and

specifically where there is room for improvement compared to other hospitals in the area. To

address the issue of extended ED wait times, a team-based approach to care and medical doctor

triage can significantly reduce time waiting and increase patient satisfaction.
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References

Centers for Disease Control & Prevention. (2016). National and state healthcare associated

infections progress report. Retrieved from https://www.cdc.gov/hai/pdfs/progress-

report/hai-progress-report.pdf.

Hospital Care Data Reporting. (2016). Chesapeake regional medical center data. Retrieved from

https://hospitalcaredata.com/facility/chesapeake-general-hospital-chesapeake-va-23320.

Hospital Care Data Reporting. (2016). Sentara norfolk general hospital data. Retrieved from

https://hospitalcaredata.com/facility/sentara-norfolk-general-hospital-norfolk-va-23507

Jarvis, P. R. (2016). Improving emergency department patient flow. Clinical and Experimental

Emergency Medicine Journal, 3(2), 63-68. doi: 10.15441/ceem.16.127. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051606/

Medicare. (2018). Hospital comparison chesapeake, norfolk, portsmouth. Retrieved from

https://www.medicare.gov/hospitalcompare/compare.html#cmprTab=0&vwgrph=0&cmprID=49

0007%2C490120&cmprDist=3.1%2C8.3&dist=25&lat=36.8274757&lng=-

76.3116235&loc=23704.

Shen, Y., & Lee, L.H. (2018). Improving the wait time to consultation at the emergency

department. British Medical Journal, 7(1), 131. doi:10.1136/bmjoq-2017-000131.

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759711/

The Leapfrog Group. (2020). Bon secours maryview medical center safety grade. Retrieved from

https://www.hospitalsafetygrade.org/h/bon-secours-maryview-medical-center?

findBy=city&city=Portsmouth&state_prov=VA&rPos=163&rSort=distance
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The Leapfrog Group. (2020). Chesapeake regional medical center hospital safety grade.

Retrieved from https://www.hospitalsafetygrade.org/h/chesapeake-regional-medical-

center?findBy=city&city=Portsmouth&state_prov=VA&rPos=739&rSort=distance.

The Leapfrog Group. (2020). Sentara norfolk general hospital safety grade. Retrieved from

https://www.hospitalsafetygrade.org/table-details/sentara-norfolk-general-hospital?

findBy=city&city=Portsmouth&state_prov=VA&rPos=273&rSort=distance.
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Appendices

Appendix A

Complete Data Table of Researched Benchmarking Areas of Focus

Appendix B

Colon Surgery Infection Rate Comparison Graph

Appendix C

Patient Satisfaction Graph Comparison Graph

Appendix D

Emergency Department Wait Times Comparison Graph

Appendix E

Pneumonia Readmission & Mortality Rate Comparison Graph

Honor Code Statement

I pledge to support the honor system of Old Dominion University. I will refrain from any form of
academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member
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of the academic community it is my responsibility to turn in all suspected violations of the Honor
Code. I will report to a hearing if summoned.

Jessica Snow