Measuring for improvement

the model for improvement

Now we have described where we are going, we need to establish some indicators that tell us whether we are heading in the right direction and to help us make decisions.

This step is all about identifying the measures or observations that will tell us how we are getting on and help us to answer the question ‘how will we know that a change is an improvement?’.

Sometimes the indicators may be less tangible observations that could be captured in other ways – perhaps through pictures or brief surveys etc. so don't always think it has to be about hard data.  That will be needed, but softer measures are important to. 

There are three categories of measure that you will want to consider keeping track of:



Outcome –measure of impacts on the ‘end user’ (service user, carers, customers, other stakeholders etc.) Examples could include; 28 day access, medication errors or recovery rates)

Process –measure of how the parts of the system are performing that help deliver the outcomes. Examples could be percentage of physical health checks completed or numbers of invoices paid on date

Balancing – measure of whether the changes we are implementing are having an adverse effect elsewhere in the system. An example could be length of stay reduction in inpatient units resulting in an increase in readmissions

Remember that whatever measures you set up may not need to be kept in place for ever – or they may replace other indicators that are no longer relevant.

Measurement and the various tools that can help this can sometimes be a complex topic, so try and keep things simple to start with. It may be that you have people in your project team who are have the right skills and knowledge, even if that isn't part of their 'day job' and you should draw upon those hidden talents wherever possible.

It may be that you would benefit from getting support from colleagues in the Performance Improvement Team to help with this element if it is outside your teams comfort zone or current skill set. However don’t be scared of it. Get the help but in a way that you learn and can be self-sufficient going forward.

The measurement step is as important as making changes to the work you do but one that is sometimes overlooked or ignored.  Don't make that mistake on your project.

Identify the measures that are relevant and then take a baseline measurement of them all before you start making changes. Capture the measures and baseline on the project template.

Feel free to improvise as well.  You may find it helpful to set up another sheet to go with your template to show run charts, pictures and other visualisations of your measurements.