Measurement is critical for improvement. Measurement is the only way to know if a change has led to improvement. Improvement teams should review data frequently, using time series charts or advanced run charts, to determine progress towards their improvement goals. Time series charts show data over time intervals and empower teams to make immediate evidence-based decisions about improvement. Training modules Focus on Measurement: Part 1 and Part 2 provide resources for basic training in measurement. Specific resources on the use of time series charts include:
- Guidance for Analyzing Quality Improvement Data Using Time Series Charts
- Norms for Presentation of Time Series Charts
Although these tools reference the use of computer programs such as Excel, time series charts can easily be created using pencil and paper.
In order to have accurate data, a tem needs to have a reliable data system. This may require that the data systems themselves are in need of improvement approach to bring them up to a function level, which requires
- Clearly defined and tested indicators
- Standard records and tools
- Timely and accurate entry of data into records or tools
- Valid sampling technique, if sampling is required
- Accurate abstraction of data from records on a regular basis
- Communication of data from abstraction to data entry clerk or other person responsible for aggregation
- Concise tools for summarizing and aggregating data
- Data entry process and systems, such as Excel databases
- Creation of charts or graphs to display results
- Communication of results to team or group responsible for improvement as well as for higher levels of the system
- Validation approaches for checking accuracy of the data
Below are a few resources to help with these crucial steps:
- Team-level Excel Database
- Multiple site aggregated Excel Database
- The Red Bead Game can be used to explain and understand variation in a process or system.
- HealthQual provides a data toolkit with multiple tools and guides for measuring improvement and using data
- National Quality Center Game Guide contains several exercises focused on teaching measurement.
- IHI Open School is a free online resource for courses and certificates in healthcare improvement and patient safety designed for health professionals around the world. They offer a specific course on Measuring for Improvement.