8/7/2019 IHI - Successful Measurement for Improvement

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An article from IHI.org

Successful Measurement for Improvement

Successful measurement is a cornerstone of successful improvement. How do you know if the changes you

are making are leading to improvement? Simple: you measure. Measurement doesn¶t have to be difficult ortime-consuming. The key is to pick the right measurements, so that you can see results quickly and adapt

your interventions accordingly, putting less strain on resources and more focus on outcomes.

Want Different Results? Create a New System.

If you own a Honda Civic and want to be a race car driver, you probably won¶t spend your money on asouped-up engine and extra turbo for your Civic. In the same way, simply adding more people or otherwise"tweaking" the same system won¶t achieve breakthrough results. You must create a different system inorder to get different results.

Make Measurement Rewarding

In health care, measurements are often used for reporting aggregate results to regulators, legislators, andother parties that "judge" the data against specific standards or rules. This "measurement for judgment" canbe understandably daunting to staff.

How can we make measuring an exciting learning experience in our organizations? Here are some signs of aculture in which measurement is an exciting, productive process:

1.  Senior management communicates improvement as an exciting challenge for the organization.

2.  Measurement initiatives for improvement are clearly separated from measurements needed foraccreditation or other external purposes.

3.  Improvement teams set attainable goals and get constant visual feedback.

When people see that they can effect change, results will become more of a personal goal.

Some Measurement Guidelines

The following guidelines are important to have in mind when beginning to measure and can help lead to asuccessful improvement project:

y  Be sure that the improvement goal, or aim, is:

o  Strategic

o  R elevant

o  Compelling

o  Important

o  A stretch (i.e., challenging but not unattainable)

o  Achievable

o  Unambiguous

y  The key measure should clarify the aim and make it tangible.

y  Don¶t track too many process measures (vs. outcome measures).

y  Use sampling to make measurement efficient and representative.

y  Integrate measurement into people¶s daily routine.

y  Plot data on the measures over time.

The strategies outlined below expound on these guidelines.

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The best way to collect and display data is to use a run chart ² a graphical record of a measure plotted overtime (usually months), sometimes called a time series graph. Charts annotated with changes and events

provide even more information and can help you to make connections between interventions/events andoutcomes more accurately.

Strategy 5: Develop excellent visual displays of measures. 

Visual displays are motivators, reality checks, and validators of work already done. They don¶t need to beperfect, just useful. And don¶t wait until the glitzy information system is ready; start with simple datacollection such as paper and pencil.