TO MEASURE OR NOT TO MEASURE, THAT IS THE QUESTION

10 TAKEAWAYS: Indicators for Patient Safety

 In an effort to use the latest tools in healthcare, a leading hospital embarks on an ambitious plan to use indicators to increase patient safety. The hospital forges full steam ahead, but fails.

What happened? Turns out, the data was useless. Not only was the plan poorly thought out, staff measured the wrong things, which led to wrong conclusions. It was a failed experiment.

How can we avoid costly mistakes like these and ensure we are on the right track? For hospitals, properly structured measurement systems play a huge role in patient safety.  A clear correlation between outcomes and processes ensures the clearest insights. Therefore, management guru Peter Drucker was right: “If you can’t measure it, you cannot improve it.” After measuring, it is critical to analyze the data for a suggested three-month data period.

Dr. Anand, Head of Quality for Manipal Health Enterprises, gave the following roadmap when creating an action plan, and recommended the following:

 TIP 1: DEFINE THE PURPOSE

 Be clear and purposeful. Don’t collect for the sake of collecting. Be specific from the beginning, and ask why you are measuring these indicators and what do you want to achieve? How will capturing data make a difference? If we do not know the “why,” we end up measuring with zero results. Remember, measuring is additional work, but it pays off as it provides a starting point.

TIP 2: DEFINE WHAT TO MEASURE

Measure the right indicator or else it is measuring for the sake of measurement. There is no use in measuring processes that do not affect outcomes, or outcomes that are not affected by processes. Is it better to use structure, process or outcome-based indicators? Keep in mind: structure-related indicators are easier to capture but more difficult to change, such as budget or headcount. NOTE: External accreditation or certification bodies have separate requirements and indicators.

TIP 3: DON’T COMPARE APPLES TO ORANGES

When using templates, make sure definitions and terminology are clear, or else staff will compare the wrong things. For example, there are 20 definitions for a fall.

TIP 4: SAMPLE WISELY

Use the principles of biostatistics, a sample stratified strategy, and compare to the previous three months with running averages.

TIP 5: NO EXCUSE FOR PAPER PUSHERS

Is it best to record data on paper or digitally? There are pros and cons to both. Just make sure that you measure, any way you can. Remember, there is no excuse if you don’t have the latest computers or IT systems.

TIP 6: APPLES TO APPLES?

Don’t blindly trust numbers. If something looks strange, investigate. Determine when you will verify indicators. What if there are errors in how the data is captured or entered? Manipal Hospitals looks at trends of the past few months. If there is an outlier, it is key to verify the data using random raw data sheets. Compare apples to apples.

TIP 7: A PICTURE IS WORTH A THOUSAND WORDS

Visually striking and entertaining graphs and charts are more easily remembered. Use visually appealing, color-coded dashboards or green and red “go and stop” lights.

TIP 8: SET BENCHMARKS

Benchmarks provide starting points. Without them, data is out of context, and we cannot say whether something is good or bad, or if there is progress. What is the best and the worst? We don’t know before we compare. It is possible to use historical, national and international data, as well as internal or external benchmarks. Benchmarks include month to date, peer average, or year to date.

TIP 9: TALK MORE

Staff are motivated by feedback. Once the data arrives, share conclusions. Keep them interested by informing them of developments. Communicate with all stakeholders. Ask what benchmark is appropriate to communicate? Use internal meetings, newsletters, email, town halls.

TIP 10: NOTHING IS SET IN STONE

Flexible, live processes must be refreshed all the time, and indicators are not set in stone. Revise indicators at established intervals to evaluate effectiveness, and review them once a year.

The takeaways above are from IFC’s full webinar on measuring healthcare quality. To watch please visit: https://www.youtube.com/watch?v=xI1hI-ov6K4&t=1454s

The webinar’s presenters are:

00:08:23 Dr. Ajibike Oyewumi, MD, Healthcare Quality and Patient Safety Expert, IFC

00:38:37 Dr. Anand R, Head of Quality, Manipal Health Enterprises

01:05:42 Aafke de Graaff, Head of SafeCare, PharmAccess Foundation

This event is organized by the IFC, a member of the World Bank Group, in partnership with the governments of Japan, Norway and the Netherla