An Introduction to Peer Selection for Benchmarking

The appropriate selection of peers is an important component of benchmarking. Because BIG Benchmarking is a comparison to the actual results of peer organizations, benchmarking results can be drastically different for different peer groups.

For all Member Hospitals, the Benchmarking Survey results are presented based on two peer groups: acute and non-acute hospitals. An updated version of the BIG Benchmarking Tool (due out in the fall of 2020) will provide additional peer group options that will allow all Members to select between Teaching, Large Community, and Small Hospital peer groups.

Subscribing Members can use the Peer Group Management tool to create any number of custom peer groups for benchmarking analyses. Peer groups can be established for concentrated analyses such as comparing similar departments across various organizations (such as the OR or ICU) or for broader comparisons at the level of the entire organization. We suggest that organizations begin with a peer group designed with the overall organization in mind. For such a peer group we typically look for between 12-20 peers based on similarities in size and range of clinical services. Factors for consideration include:

  • Total Direct Care Expenses
  • Total Inpatient Acute Patient Days
  • Mix of Programs and Services (e.g. ED, ICU, Rehab)
  • Type of Organization (for example Teaching, Large Community, Small Community)
  • Location of Organization (for example Northern Rural vs. Urban Central)
  • Multi-Site vs. Single-Site Organizations

While no one organization will be exactly similar, a group of “comparable peers” can be selected based on a number of parameters that are in common.

When conducting concentrated analysis into a particular department, it is often helpful to create a distinct peer group based on similarities at the department level. For example, an investigation of the obstetric department would benefit from a distinct peer group of hospitals with similar size and volume of obstetrical activity.

When benchmarking clinical areas, peer groups can be based on similar patient volumes. When benchmarking administrative areas, peer groups can be based on similar direct care costs. The notion is that hospitals with similar direct care costs will generally require a similar level of administrative services to support their functions. For certain Functional Centres such as Plant Operations and Housekeeping, peer groups can be based on the size of the organization (net square metres).

Within the BIG tools, under Reference Reports, is a report titled Workload by Functional Centre for all Member hospitals. This report provides the activity (workload) that is used to calculate indicators by each Functional Centre. You can use this report to identify peers that have similar activity to your hospital for the particular Functional Centre you are investigating.

There is no limit to the number of peer groups that can be created in the tool. Distinct peer groups can be used for each functional area that you are investigating to ensure you are comparing your hospital to the most relevant set of peers.

There is no “science” to choosing peer groups. Ultimately choosing organizations that are as similar as possible is the goal. There is no “right” answer. This is why we have included a dynamic Peer Group Management Tool that allows our Subscribing Members to establish as many peer groups as they like.