Benchmarking in Health-System Pharmacy
The application of benchmarkging techniques to hospital pharmacy practice is discussed.

Benchmarking is a process designed to discover best practices through a comparison of various competing methods aimed at achieving a particular goal. Benchmarking antimicrobial drug utilization and rates of bacterial resistance through comparison with a multitude of similar hospitals can be used by an institution both to identify potential problem areas in its pharmacy practice and to aid in establishing appropriate and attainable goals. The effectiveness of various activities targeted at reducing appropriate drug use can also be benchmarked. In 1993, the Benchmarking Program was established at Millard Fillmore Hospital. This program consists of a network of hospital pharmacists who supply data on antimicrobial use, antimicrobial management activities, and rates of antimicrobial resistance. The program was designed both to serve hospital pharmacies in optimizing antimicrobial management and to create a national database for evaluating relationships among antimicrobial use, management, and resistance. Hospitals participating in the Benchmarking Program receive an annual report that allows them to compare themselves with peer groups and with best-performing "benchmark hospitals." All data from U.S. hospitals contained in the Benchmarking Program database are pooled and analyzed to identify meaningful trends. However, information gained from the institutionwide data must be supplemented by studies at the patient level.

Benchmarking antimicrobial drug use in an institutional setting can identify successes as well as potential problem areas in pharmacy practice and aid in establishing appropriate and attainable goals.

In 1993, the Benchmarking Program was established at The Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital in Buffalo, New York. This program consists of a network of health-system pharmacists across the United States who supply hospitalwide data, including data on antimicrobial use, antimicrobial management activities, and rates of bacterial resistance to commonly used antimicrobial agents. The program was designed (1) to assist health-system pharmacies in optimizing their antimicrobial management programs in order to reduce inappropriate drug use, reduce the emergence of antimicrobial resistance, and justify existing or additional pharmacist full-time equivalents (FTEs) and (2) to create a national database from which the relationships among antimicrobial use, antimicrobial management activities, and resistance can be evaluated.

This article discusses the application of benchmarking techniques to hospital pharmacy practice. Particular attention is given to our experiences with the Benchmarking Program.