Using Measures for Improvement

What do we mean when we talk about measures in quality improvement? We’ve received a number of requests for guidance on how to use measures in your projects.

Why do we need to collect measurement data?  

You have a project, with an aim and some ideas for change. How will you know that the changes you make have resulted in improvement? As we learnt form IHI Open School, improvement requires change, but not every change will result in an improvement.

Measurement in improvement is intended to establish the baseline from which we are operating, to track the impact of the changes we make, to allow us to display the impact of our work, and to determine our goals for future work.

Establishing a baseline understanding of the numbers involved helped us to be clear about the outcome measures we wanted to use.

Once we had established change ideas, we used process measures to establish whether we were on track – i.e. numbers of falls assessment completed.

Manually collect the data on a spread sheet. It is best to do this weekly. If the data collection is really time consuming, take a sample of patient records in order to gather improvement data.

There are three types of measures we are asking you to define in your charter:

Outcome: How will you measure success: e.g. number of referrals received by CMHT, number of patients very satisfied/ satisfied with service?

Process:  Are the parts/steps in the system performing as planned? Are we on track in our efforts to improve the system? E.g. Number of monitoring forms completed, number of surveys completed

Balancing:  Are changes designed to improve one part of the system causing any differences in other parts of the system? E.g. If you were working to reduce levels of physical violence, you might want to keep an eye on the amount of PRN medication being prescribed or seclusion use

If you need help on establishing measures, talk to your QI support:

• Tsana Rawson: City and Hackney, Tower Hamlets, Specialist Services
• Genevieve Holt:  Newham, Forensics, Multiple Directorates.
• Juliette Brown: MHCOP, Community Health Newham, Corporate Services.

Next time we will look more closely at tracking and displaying data graphically.