Who Decided the Benchmark Was the Goal?
Consider a healthcare leadership team reviewing a performance measure that has been sitting below an external benchmark.
The organization is at 81%. The benchmark is 87%. This isn't the first time the measure has been on the agenda. The team has reviewed the process, made changes, talked with the people responsible for the work, and watched the number improve for a while before leveling off.
Now it is back on the screen. Six points below the benchmark.
The conversation turns to what it will take to close the gap. What else can we try? What are higher-performing organizations doing differently? Is there another process that needs to change? Who owns getting us the rest of the way there? All of those are reasonable questions, but there is another one I would want to ask before deciding what comes next.
What do we know about the organizations producing 87%?
I don't mean what they did to improve the measure. I want to know something about the environments producing the performance we're now using as our comparison. Who are they serving? How are they staffed? What resources are available to the people doing the work? How similar are their operating conditions to ours?
Maybe the comparison holds up extremely well. Maybe 87% is exactly where this organization should be. I would want to know that before six points became the problem everyone is trying to solve.
Something happens when a benchmark enters the conversation. Healthcare organizations use benchmarks everywhere: quality, patient experience, workforce, access, length of stay, financial performance, clinical outcomes. They give leaders an important view beyond their own walls and can expose performance that looks acceptable internally but isn't when compared with what others are achieving. They also carry a lot of authority.
Once 87% appears on the screen as the benchmark, it quickly becomes an unimpeachable truth. We are at 81%, so we have a six-point performance gap. From there, the conversation changes. We start talking about what needs to happen to close the gap. We look for best practices. We assign accountability. We study organizations that are doing better. Eventually, another initiative is launched.
Somewhere along the way, a different question disappears: What is producing 81% here?
Asking that takes the conversation in a different direction. Maybe one department is already at 88% while another is at 73%. Maybe performance changes by shift or day of the week. Maybe the process requires staffing, technology, equipment, or time that isn't consistently available. Maybe the operation has changed considerably since the original performance expectation was established.
I don't know which of those things is true. That's why I want to ask. The 81% is performance this organization produced under its particular conditions, with the people and resources available to it. Understanding those conditions takes work. A benchmark is much easier to see. We know the number. We know our number. We can calculate the difference between them in seconds.
That clarity is useful, but it can also allow the benchmark to become a substitute for understanding the environment. Nobody has to make that choice intentionally. The gap simply gives the conversation somewhere obvious to go. Before long, leadership knows quite a bit about the six points it is trying to close and considerably less about why the organization is producing 81% in the first place.
Knowing the size of the gap is not the same as understanding the problem.
This matters when leaders begin looking outside the organization for ways to improve. Suppose another health system has consistently achieved 89% and has a practice that appears to be contributing to it. There is good reason to pay attention. We should learn from organizations producing better results, but I would also want to understand the conditions surrounding that practice before bringing it home.
A process that works with one staffing model may behave differently with another. The same is true when patient populations, technology, resources, workflows, or competing priorities differ. What looks like a best practice when viewed from the performance report may depend on parts of the operating environment that don't travel with the practice.
That doesn't mean we dismiss the comparison because we're different. Every organization could explain away poor performance that way. It means we understand the comparison well enough to decide what to do with it.
At some point, leadership has to make a decision the benchmark cannot make for them: Is 87% the appropriate performance expectation for this organization?
Answering yes requires more than knowing that someone else got there. It requires understanding enough about their performance and ours to know what the comparison means.
The 2026 NSI National Health Care Retention & RN Staffing Report makes the point well. It includes data from 527 hospitals across 40 states and reports a national staff RN turnover rate of 17.6%, while the results underneath that aggregate vary considerably across hospitals. NSI itself directs organizations to use different benchmarking statistics depending on which employment classifications they include in their turnover calculations.
The national number is useful, and so is understanding what went into it. The same principle applies well beyond turnover.
A benchmark should make us curious about organizations producing better performance. What are they doing? What conditions support it? What could we learn from them? It should also make us curious about our own. What is producing our current performance? Where inside the organization is that performance different? What conditions are present where the number is better? What conditions are present where it is worse?
After answering those questions, leadership may decide 87% is exactly the right expectation. If it is, understanding the environment doesn't lower the bar. It gives the organization a better chance of knowing what actually has to change to reach it.
The benchmark gives you a number. Leadership still has to decide what that number means here.
What is producing your current performance?
A benchmark can tell a leadership team how its performance compares. It cannot tell the team what is producing its performance.
The Organizational Performance Diagnostic helps healthcare leadership teams work backward from the performance they can see to examine the leadership decisions, organizational conditions, and adaptations producing it.
If your team knows the size of the performance gap but still can't explain what is producing the number you have today, that's a useful place for us to start.
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