Benchmarking outcomes on multiple contextual levels in lean healthcare: a systematic review, development of a conceptual framework, and a research agenda

Bibliographic Details
Title: Benchmarking outcomes on multiple contextual levels in lean healthcare: a systematic review, development of a conceptual framework, and a research agenda
Authors: Elina Reponen, Thomas G. Rundall, Stephen M. Shortell, Janet C. Blodgett, Angelica Juarez, Ritva Jokela, Markku Mäkijärvi, Paulus Torkki
Source: BMC Health Services Research, Vol 21, Iss 1, Pp 1-18 (2021)
Publisher Information: BMC, 2021.
Publication Year: 2021
Collection: LCC:Public aspects of medicine
Subject Terms: Lean management, Lean healthcare, Benchmarking, Context, Outcomes, Public aspects of medicine, RA1-1270
More Details: Abstract Background Reliable benchmarking in Lean healthcare requires widely relevant and applicable domains for outcome metrics and careful attention to contextual levels. These levels have been poorly defined and no framework to facilitate performance benchmarking exists. Methods We systematically searched the Pubmed, Scopus, and Web of Science databases to identify original articles reporting benchmarking on different contextual levels in Lean healthcare and critically appraised the articles. Scarcity and heterogeneity of articles prevented quantitative meta-analyses. We developed a new, widely applicable conceptual framework for benchmarking drawing on the principles of ten commonly used healthcare quality frameworks and four value statements, and suggest an agenda for future research on benchmarking in Lean healthcare. Results We identified 22 articles on benchmarking in Lean healthcare on 4 contextual levels: intra-organizational (6 articles), regional (4), national (10), and international (2). We further categorized the articles by the domains in the proposed conceptual framework: patients (6), employed and affiliated staff (2), costs (2), and service provision (16). After critical appraisal, only one fifth of the articles were categorized as high quality. Conclusions When making evidence-informed decisions based on current scarce literature on benchmarking in healthcare, leaders and managers should carefully consider the influence of context. The proposed conceptual framework may facilitate performance benchmarking and spreading best practices in Lean healthcare. Future research on benchmarking in Lean healthcare should include international benchmarking, defining essential factors influencing Lean initiatives on different levels of context; patient-centered benchmarking; and system-level benchmarking with a balanced set of outcomes and quality measures.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1472-6963
Relation: https://doaj.org/toc/1472-6963
DOI: 10.1186/s12913-021-06160-6
Access URL: https://doaj.org/article/d891094e660f4b29afc2aeae8278c90f
Accession Number: edsdoj.891094e660f4b29afc2aeae8278c90f
Database: Directory of Open Access Journals
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More Details
ISSN:14726963
DOI:10.1186/s12913-021-06160-6
Published in:BMC Health Services Research
Language:English