Browsing by Subject "Benchmarking"

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  • Reponen, Elina; Rundall, Thomas G.; Shortell, Stephen M.; Blodgett, Janet C.; Juarez, Angelica; Jokela, Ritva; Mäkijärvi, Markku; Torkki, Paulus (2021)
    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.
  • Reponen, Elina; Rundall, Thomas G; Shortell, Stephen M; Blodgett, Janet C; Juarez, Angelica; Jokela, Ritva; Mäkijärvi, Markku; Torkki, Paulus (BioMed Central, 2021)
    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.
  • Wind, Anke; van Dijk, Joris; Nefkens, Isabelle; van Lent, Wineke; Nagy, Peter; Janulionis, Ernestas; Helander, Tuula; Rocha-Goncalves, Francisco; van Harten, Wim (2018)
    Background: Differences in cancer survival exist between countries in Europe. Benchmarking of good practices can assist cancer centers to improve their services aiming for reduced inequalities. The aim of the BENCH-CAN project was to develop a cancer care benchmark tool, identify performance differences and yield good practice examples, contributing to improving the quality of interdisciplinary care. This paper describes the development of this benchmark tool and its validation in cancer centers throughout Europe. Methods: A benchmark tool was developed and executed according to a 13 step benchmarking process. Indicator selection was based on literature, existing accreditation systems, and expert opinions. A final format was tested in eight cancer centers. Center visits by a team of minimally 3 persons, including a patient representative, were performed to verify information, grasp context and check on additional questions (through semi-structured interviews). Based on the visits, the benchmark methodology identified opportunities for improvement. Results: The final tool existed of 61 qualitative and 141 quantitative indicators, which were structured in an evaluative framework. Data from all eight participating centers showed inter-organization variability on many indicators, such as bed utilization and provision of survivorship care. Subsequently, improvement suggestions for centers were made; 85% of which were agreed upon. Conclusion: A benchmarking tool for cancer centers was successfully developed and tested and is available in an open format. The tool allows comparison of inter-organizational performance. Improvement opportunities were successfully identified for every center involved and the tool was positively evaluated.
  • Cubbage, Frederick; Kanieski, Bruno; Rubilar, Rafael; Bussoni, Adriana; Morales Olmos, Virginia; Balmelli, Gustavo; Mac Donagh, Patricio; Lord, Roger; Hernandez, Carmelo; Zhang, Pu; Huang, Jin; Korhonen, Jaana; Yao, Richard; Hall, Peter; Del La Torre, Rafael; Diaz-Balteiro, Luis; Carrero, Omar; Monges, Elizabeth; Ha Tran Thi Thu,; Frey, Gregory; Howard, Mike; Chavet, Michael; Mochan, Shaun; Hoeflich, Vitor Afonso; Chudy, Rafal; Maass, David; Chizmar, Stephanie; Abt, Robert (2020)
    We estimated timber investment returns for 22 countries and 54 species/management regimes in 2017, for a range of global timber plantation species and countries at the stand level, using capital budgeting criteria, without land costs, at a real discount rate of 8%. Returns were estimated for the principal plantation countries in the Americas-Brazil, Argentina, Uruguay, Chile, Colombia, Venezuela, Paraguay, Mexico, and the United States-as well as New Zealand, Australia, South Africa, China, Vietnam, Laos, Spain, Finland, Poland, Scotland, and France. South American plantation growth rates and their concomitant returns were generally greater, at more than 12% Internal Rates of Return (IRRs), as were those in China, Vietnam, and Laos. These IRRs were followed by those for plantations in southern hemisphere countries of Australia and New Zealand and in Mexico, with IRRs around 8%. Temperate forest plantations in the U.S. and Europe returned less, from 4% to 8%, but those countries have less financial risk, better timber markets, and more infrastructure. Returns to most planted species in all countries except Asia have decreased from 2005 to 2017. If land costs were included in calculating the overall timberland investment returns, the IRRs would decrease from 3 percentage points less for loblolly pine in the U.S. South to 8 percentage points less for eucalypts in Brazil.
  • Zhang, Chao; Lu, Jiaheng (2021)
    A multi-model database (MMDB) is designed to support multiple data models against a single, integrated back-end. Examples of data models include document, graph, relational, and key-value. As more and more platforms are developed to deal with multi-model data, it has become crucial to establish a benchmark for evaluating the performance and usability of MMDBs. In this paper, we propose UniBench, a generic multi-model benchmark for a holistic evaluation of state-of-the-art MMDBs. UniBench consists of a set of mixed data models that mimics a social commerce application, which covers data models including JSON, XML, key-value, tabular, and graph. We propose a three-phase framework to simulate the real-life distributions and develop a multi-model data generator to produce the benchmarking data. Furthermore, in order to generate a comprehensive and unbiased query set, we develop an efficient algorithm to solve a new problem called multi-model parameter curation to judiciously control the query selectivity on diverse models. Finally, the extensive experiments based on the proposed benchmark were performed on four representatives of MMDBs: ArangoDB, OrientDB, AgensGraph and Spark SQL. We provide a comprehensive analysis with respect to internal data representations, multi-model query and transaction processing, and performance results for distributed execution.
  • Liang, Xinlian; Hyyppä, Juha; Kaartinen, Harri; Lehtomäki, Matti; Pyörälä, Jiri; Pfeifer, Norbert; Holopainen, Markus; Brolly, Gábor; Francesco, Pirotti; Hackenberg, Jan; Huang, Huabing; Jo, Hyun-Woo; Katoh, Masato; Liu, Luxia; Mokroš, Martin; Morel, Jules; Olofsson, Kenneth; Poveda-Lopez, Jose; Trochta, Jan; Wang, Di; Wang, Jinhu; Xi, Zhouxi; Yang, Bisheng; Zheng, Guang; Kankare, Ville; Luoma, Ville; Yu, Xiaowei; Chen, Liang; Vastaranta, Mikko; Saarinen, Ninni; Wang, Yunsheng (2018)
    The last two decades have witnessed increasing awareness of the potential of terrestrial laser scanning (TLS) in forest applications in both public and commercial sectors, along with tremendous research efforts and progress. It is time to inspect the achievements of and the remaining barriers to TLS-based forest investigations, so further research and application are clearly orientated in operational uses of TLS. In such context, the international TLS benchmarking project was launched in 2014 by the European Spatial Data Research Organization and coordinated by the Finnish Geospatial Research Institute. The main objectives of this benchmarking study are to evaluate the potential of applying TLS in characterizing forests, to clarify the strengths and the weaknesses of TLS as a measure of forest digitization, and to reveal the capability of recent algorithms for tree-attribute extraction. The project is designed to benchmark the TLS algorithms by processing identical TLS datasets for a standardized set of forest attribute criteria and by evaluating the results through a common procedure respecting reliable references. Benchmarking results reflect large variances in estimating accuracies, which were unveiled through the 18 compared algorithms and through the evaluation framework, i.e., forest complexity categories, TLS data acquisition approaches, tree attributes and evaluation procedures. The evaluation framework includes three new criteria proposed in this benchmarking and the algorithm performances are investigated through combining two or more criteria (e.g., the accuracy of the individual tree attributes are inspected in conjunction with plot-level completeness) in order to reveal algorithms’ overall performance. The results also reveal some best available forest attribute estimates at this time, which clarify the status quo of TLS-based forest investigations. Some results are well expected, while some are new, e.g., the variances of estimating accuracies between single-/multi-scan, the principle of the algorithm designs and the possibility of a computer outperforming human operation. With single-scan data, i.e., one hemispherical scan per plot, most of the recent algorithms are capable of achieving stem detection with approximately 75% completeness and 90% correctness in the easy forest stands (easy plots: 600 stems/ha, 20 cm mean DBH). The detection rate decreases when the stem density increases and the average DBH decreases, i.e., 60% completeness with 90% correctness (medium plots: 1000 stem/ha, 15 cm mean DBH) and 30% completeness with 90% correctness (difficult plots: 2000 stems/ha, 10 cm mean DBH). The application of the multi-scan approach, i.e., five scans per plot at the center and four quadrant angles, is more effective in complex stands, increasing the completeness to approximately 90% for medium plots and to approximately 70% for difficult plots, with almost 100% correctness. The results of this benchmarking also show that the TLS-based approaches can provide the estimates of the DBH and the stem curve at a 1–2 cm accuracy that are close to what is required in practical applications, e.g., national forest inventories (NFIs). In terms of algorithm development, a high level of automation is a commonly shared standard, but a bottleneck occurs at stem detection and tree height estimation, especially in multilayer and dense forest stands. The greatest challenge is that even with the multi-scan approach, it is still hard to completely and accurately record stems of all trees in a plot due to the occlusion effects of the trees and bushes in forests. Future development must address the redundant yet incomplete point clouds of forest sample plots and recognize trees more accurately and efficiently. It is worth noting that TLS currently provides the best quality terrestrial point clouds in comparison with all other technologies, meaning that all the benchmarks labeled in this paper can also serve as a reference for other terrestrial point clouds sources.
  • Reponen, Elina; Tuominen, Hanna; Korja, Miikka (2019)
    BACKGROUND: Multiple nationwide outcome registries are utilized for quality benchmarking between institutions and individual surgeons. OBJECTIVE: To evaluate whether nationwide quality of care programs in the United Kingdom and United States can measure differences in neurosurgical quality. METHODS: This prospective observational study comprised 418 consecutive adult patients undergoing elective craniotomy at Helsinki University Hospital between December 7, 2011 and December 31, 2012.We recorded outcome event rates and categorized them according to British Neurosurgical National Audit Programme (NNAP), American National Surgical Quality Improvement Program (NSQIP), and American National Neurosurgery Quality and Outcomes Database (N(2)QOD) to assess the applicability of these programs for quality benchmarking and estimated sample sizes required for reliable quality comparisons. RESULTS: The rate of in-hospital major and minor morbidity was 18.7% and 38.0%, respectively, and 30-d mortality rate was 2.4%. The NSQIP criteria identified 96.2% of major but only 38.4% of minor complications. N(2)QOD performed better, but almost one-fourth (23.2%) of all patients with adverse outcomes, mostly minor, went unnoticed. For NNAP, a sample size of over 4200 patients per surgeon is required to detect a 50.0% increase in mortality rates between surgeons. The sample size required for reliable comparisons between the rates of complications exceeds 600 patients per center per year. CONCLUSION: The implemented benchmarking programs in the United Kingdom and United States fail to identify a considerable number of complications in a high-volume center. Health care policy makers should be cautious as outcome comparisons between most centers and individual surgeons are questionable if based on the programs.
  • Froleyks, Nils; Heule, Marijn; Iser, Markus; Järvisalo, Matti; Suda, Martin (2021)
    The SAT Competitions constitute a well-established series of yearly open international algorithm implementation competitions, focusing on the Boolean satisfiability (or propositional satisfiability, SAT) problem. In this article, we provide a detailed account on the 2020 instantiation of the SAT Competition, including the new competition tracks and benchmark selection procedures, overview of solving strategies implemented in top-performing solvers, and a detailed analysis of the empirical data obtained from running the competition. (C) 2021 The Authors. Published by Elsevier B.V.
  • Aro, Ellinoora; Ijas, Petra; Vikatmaa, Leena; Soinne, Lauri; Sund, Reijo; Venermo, Maarit; Vikatmaa, Pirkka (2019)
    Objective: Considering carotid endarterectomy (CEA), reporting treatment delay, symptom status, and surgical complication rates separately gives an incomplete picture of efficacy; therefore, the aim was to combine these factors and develop a reporting standard that better describes the number of potentially prevented strokes. With a real life cohort and theoretical inclusion scenarios, the aim was to explore the stroke prevention potential of different carotid practices. Methods: Landmark studies for symptomatic and asymptomatic patients were revisited. By using published estimates of treatment effect, a simplified calculator was designed to assess the five year stroke prevention rate per 1000 CEAs (stroke prevention potential [SPP], range 0-478), including the presence and recentness of symptoms, sex, increasing stenosis severity, and complication rates. Patients operated on for carotid stenosis at Helsinki University Hospital (HUH) between 2008 and 2016 were collected from a vascular registry (HUSVASC) and categorised according to the model. The local annual complication rate was re-evaluated and added to the model. The HUH patient cohort was incorporated into the SPP model, and changes over time analysed. Finally, theoretical changes in patient selection were compared in order to explore the theoretical impact of patient selection and shortening of the delay. Results: Fifteen hundred and five symptomatic and 356 asymptomatic carotid stenoses were operated on with stroke plus death rates of 3.6% and 0.3%, respectively. The proportion of CEAs performed within two weeks of the index event increased over the follow up period, being 77% in 2016. The SPP increased from 123 in 2008 to 229 in 2016. Theoretically, 350 ischaemic strokes were prevented in the period 2008-16, with 1861 CEAs. Conclusions: National and international comparison of different CEA series is irrelevant if the inclusion criteria are not considered. A calculator that is easy to apply to large scale high quality registered data was developed and tested. SPP was found to increase over time, which is a probable sign of improved patient selection and an increased number of strokes prevented by the CEAs performed.