The best quality improvement initiatives are driven by data! Why? How are you
going to know how much you have improved if you don’t measure something?

All of you have been exposed to measures in many situations. Most of them were
important. In school, you were graded. Perhaps you own shares of stock; how do
you measure the success of the stockits increase in value, a measurement. How
do you know if your team wins? By its score, a measurement. The fact is that many
daily activities in life have accompanying measures to judge their success.

You might argue that you know if things are getting better; you can just tell. I am
sure that you can. This is not enough, though. In the healthcare field it is
important to measure improvement. One reason to do so is to prove to others that
things are improving. For instance, suppose you are in charge of implementing
electronic health records in a hospital setting. You meet resistance from several
staff members, including a large number of doctors. How can you overcome this
resistance? Collect datalower percentage of wrong prescriptions, for instance
from a pilot program of willing participants and then demonstrate the positive
benefits with your data. With such results in hand, you will overcome many
doubters.

Another reason to measure improvement is to demonstrate the saving of time and
money. With healthcare costing so much today that many find care out of their
price range, it is important to find ways to lower costs. For instance, suppose that
staffing at your facility is very expensive; the payroll costs are way over budget. I
recently read of a lean six sigma project that demonstrated through the use of data
collecting by staff charge nurses that staffing shortages and costs were significantly
reduced. The right staff was present when needed and the facility eliminated the
need for using short-term staffing of nurses through agencies; this saved a great
deal of money. Besides lowering costs, staff morale improved significantly at this
site.

I hope that I have convinced you that to make significant quality improvements, you
should be actively measuring. What should you be measuring? The most common
measurements are costs in providing a service, time taken in providing a service and
various measures of patient health, such as the lung capacity of asthmatics. You
can also measure improved bottom lines. One doctor I know improved his income
38% in 5 years by working hard to adopt quality measures in his solo practice. Many
ER’s now boast of how they have significantly decreased waiting time for patients.
One such local hospital did so well that they were overwhelmed by the increase of
demand for service at their ER. You might want to measure if spending a few more
minutes with patients talking about pursuing good life habits like eating the right
foods leads to improved health, like lower cholesterol.

Once you have decided what to measure, you should first measure the variable
(cost, time, etc.) as it is in the state before you begin an improvement initiative.
This is a baseline against which you can measure your improvement. As you begin
and proceed through a quality improvement effort, keep track of the measures and
see what improvements occur. I suggest that you keep the data in a spreadsheet or
database. For short term record keeping you might want to use charts. You will
want to check to see if your means are significantly improving (you can use
statistical tests if you choosethey are more accurate) and if your variation is
decreasing.

Once you have reached your goals, revisit the new processes once in a while and
collect new data on the variables you chose to measure. Doing so, will help keep
you from backsliding to the old ineffective state. Backsliding is all too easy. It is
hard to break old habits, but keeping data will help you. This is, in fact, what drives
the the success of many programs, such as Weight Watchers.

I hope that I have convinced you that data driven change is the best way to approach
quality improvement. It will concretely demonstrate how you are progressing and
will prove to others that your site is doing much better. It will help you earn your
just rewards!

Donald Bryant helps healthcare providers meet their challenges and writes
“Making Good Healthcare Better” a free monthly ezine for healthcare
providers who want to dramatically improve patient health, improve the
bottom line, and make work more rewarding, guaranteed. Go now to his
http://www.bryantsstatisticalconsulting.com to get a free article with tips you can
use to start making improvements immediately and to learn more about Lean Healthcare

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