Internal benchmarking typically involves comparing current processes and/or outcomes to baseline data or comparing different departments in the same healthcare facility [6]. Although easily accessible and potentially highly useful, the collection of baseline data that is of adequate size for statistical comparison may require a significant amount of time. Moreover, the inability to adjust for patient, healthcare, selleck products and methodological changes over time may lead to erroneous conclusions. External benchmarking, on the other hand, usually involves comparing processes and/or

outcomes in one healthcare facility to other facilities performing similar activities, often with higher standards [7]. The main challenge to external benchmarking is accounting for differences in patient risks and surveillance methodologies. The purpose of both internal and external benchmarking is to continuously improve healthcare by demonstrating strengths and weaknesses, stimulating competitiveness, and assessing the value of interventions intended to reduce

HAIs [6]. Benchmarking is often compromised by the limitation of simply comparing outcome indicators rather than analyzing and promoting the best practices [8]. Without performing these latter activities, the benchmarking of HAI data can be misleading. Furthermore, the benchmarked data must be collected using standardized case definitions as well as similar RGFP966 supplier data collection methods and in populations of adequate sizes over a sufficient duration of time, as a statistically relevant number of outcomes are required for comparison [9]. Moreover, the collected data should be analyzed and reported using similar risk-stratified or risk-adjusted metrics (rates, proportions, or ratios) to allow fair comparisons [9]. Nevertheless, Methisazone benchmarking is often performed without

fulfilling these conditions, perhaps because local policy makers poorly understand the significance of these limitations. Obviously, external benchmarking cannot be accomplished if there is no regional system for data collection and dissemination. One of the major challenges in benchmarking metrics of HAI surveillance is the heterogeneity of healthcare facilities in terms of HAI risk. The potential for healthcare facilities to report higher rates of HAIs is dependent on many factors including size (bed number) of the facility, type and complexity of the care provided (such as burn care and solid organ transplants), length of patient stay, duration and type of device use, patient risks for an HAI (such as age and immunocompromising conditions), and comorbidities (such as renal dysfunction, liver failure, obesity, and diabetes) [10], [11], [12] and [13]. Therefore, benchmarking overall (crude) HAI surveillance metrics without accounting or adjusting for these variables can result in misleading conclusions. Providing risk-adjusted metrics is one way to reduce the possibility of such erroneous conclusions [4].