Benchmarking and Management Metrics in Utilization Management

• Published in: Utilization Management in the Clinical Laboratory and Other Ancillary Services pp. 75 - 81
• Main Authors: Bixho, Ida, Melanson, Stacy E. F.
• Format: Book Chapter
• Language: English
• Published: Switzerland Springer International Publishing AG 2016; Springer International Publishing
• Subjects: Benchmarking; Benchmarking tools; Clinical laboratory; Effectiveness; Efficiency; Health & safety aspects of computing; Laboratory ut; Literature review; lization; Pathology; Utilization management; Utilization metrics
• ISBN: 3319341979; 9783319341972
• DOI: 10.1007/978-3-319-34199-6_7

In the current healthcare environment, clinical laboratories are under pressure to engage in continuous quality improvement projects and to decrease cost while increasing quality and safety. Controlling test utilization is a common initiative to meet these demands. Benchmarking can be a powerful tool to determine best practices related to utilization management, optimize test utilization, and monitor one’s progress. Before participating in benchmarking, laboratories need to decide what they hope to gain from this tool and how they will utilize the results. This chapter describes some available internal and external benchmarking tools that can be employed for utilization management, as well as each of their advantages and limitations. Common metrics to measure and monitor success are also outlined. The importance of a robust information technology infrastructure to assist with consistent and reliable metrics is emphasized. To conclude, the overall process of benchmarking and metrics in utilization management is summarized.