Developing your measures

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This page focuses on improvement project measures. We will look at how we decide what to measure, defining our measures and the different types of data.

Improvement project measures : the family of measures

Improvement projects should have a small, balanced set of measures that are tracked over time. We call these 'The Family of Measures' and these should include:

One or more outcome measures, associated with the aim of the project

Process measures, which are things that have to happen to achieve the desired outcomes, and 

Balancing measures to check for possible consequences elsewhere in the system

It can be tempting to measure a lot of things. Too much time spent collecting data could be at the expense of testing, implementing and spreading changes. The aim is improvement, not only measurement. Only measure what is useful and try to keep it as straightforward as possible.

In general, a small set of measures containing one or two outcome measures, a few process measures and a balancing measure is likely to be about right for most improvement projects.

Work out and specify how the data will be collected and monitored, and whose responsibility it is to do it. It’s important to think at the start about how you would like to analyse the data. You could use the Measurement Plan tool to help you develop and record your measures to ensure you collect all the information you need, in the right format.

Working out what to measure

Start by developing ideas for your measures.

Clarify the improvement aim and how this can best be measured

Use the driver diagram to help assess the key processes that need to be measured

Identify any potential unintended consequences of the work. Set up balancing measures for these.

Have you picked specific measures or concepts? For example ‘staff experience’ is not a measure, it is a concept. A measure for this concept might be ‘% of staff who report they had a good day’ or ‘average rating of staff on how supported they feel in their work’.

There are many options of what to measure for each concept so you need to decide what is going to be the best for you. Do not underestimate how challenging this often overlooked step can be. Build time to have the necessary discussions into your project plan and test the measures if necessary.

Types of data

You will need to decide what the most appropriate type of data will be for your measures. This depends on what you want to achieve and what you need to learn. For example, will it be a numerical measure, a percentage, a rate or a simple count?

If you want to use an SPC chart, you need to understand what type of data you have for each measure to ensure you pick the best chart for the job. The terms used for these are described below.

Types of data

When you're looking at a variable in an improvement project, like how long it takes to do something, it's better to use the real numbers instead of changing them into percentages. People often change numbers into percentages to see if they're above or below a certain goal. This is useful for tracking progress or responsibility, like meeting a target. However, doing this can hide important details in the data.

The pictures below show this. In the picture on the right, using the actual time helps the team see improvements. But in the picture on the left, improvements aren't clear.

Healthcare Data Guide
Defining your measures

Having clear and agreed definitions for each measure is crucial. If the way you collect data keeps changing, it will be hard to see how things change over time. Make sure you and your team are clear what is being measured, when, and by who. 

Operational definitions explain how we'll measure things. They describe how we'll know what we're measuring. They also say what counts and what doesn't, and sometimes even how to compare to a standard. The Measurement Plan tool will help you here. 

Characteristics of a good measure