Measurement for improvement - Criteria led discharge Samantha Riley Head of Improvement Analytics 7th August 2017 Title slide with embedded images

The Aim…………..

These are all real X

What happens when people see this? But how many times do we sit in meetings looking at data like this? Question – could we get people to ‘raise a hand’ somehow if they agree And all too often we see colour coding like this

A&E Performance Which presentation would lead you to a better discussion and decision? There are different ways to look at data. Looking at the first graph what does this tell you Question : could we get people to write answers in the chat box? This is the same data presented in a different way. The same two data points are identified. The second presentation leads you to a very different type of discussion. This is what measurement for improvement is about - looking at data over time

To make a lot of fuss about trivial things as if they were important How many trends do you see in this graph? Spuddle : To make a lot of fuss about trivial things as if they were important Downturn Upward trend Turnaround Rebound Downward trend Downward trend

NHSI report : A&E performance St Elsewhere NHS Trust

St Elsewhere NHS Trust : A&E performance This is also St Elsewhere Trust and this is monthly data Here we can see where they have improved. But what happened before then? This is an SPC chart (not going to talk about these in detail in this session). If people want to know more about SPC I have some tips at the end. Simply by plotting the dots, it is easy to see where performance is changing over time –and to investigate what might have happened and to take action Most improved ?

All improvements involve a change, but not all changes are improvements* Reference: Langley G, Nolan K, Nolan T, Norman C, Provost L, (1996) : a practical approach to enhancing organisational performance, Jossey Bass Publishers, San Francisco *Goldratt

Are your efforts making a difference? http://m.futurehospital.rcpjournal.org/content/4/1/30.full.pdf

What do you need to think about? What is your aim and key area of focus? What should you measure? What can be measured? Already collected? Is this data good enough? (Perfection should not become an enemy of the good enough) Can I/should I collect additional data? How will I collect it? What else should I measure? Might there be unintended consequences? Qualitative data How to collect a baseline Presenting the data in a meaningful way – plot the dots Use the data!

7 steps to measurement A measurement for improvement community of interest has already been established. Within only a few weeks there are over 200 members. There are 40 useful resources and some lively discussion forums. Contact Sam to get involved

Deciding where to focus : 80/20 rule

Discharges by day

Evidence of impact

An approximate answer to the right problem is worth a good deal more than an exact answer to an approximate problem* Be clear about your aim – what question are you trying to answer? Once you are clear on this talk to an analyst! * W. Edwards Deming

The importance of taking a baseline Intervention made

Just because you can measure everything doesn’t mean you should* * W. Edwards Deming

The power of story telling

Where to go for help…….. On-line community Over 300 members Resources Discussions Sharing good practice Virtual support network Over 300 members Series of webinars planned Email me if you would like to join! Samantha.riley1@nhs.net @samriley A measurement for improvement community of interest has already been established. Within only a few weeks there are over 200 members. There are 40 useful resources and some lively discussion forums. Contact Sam to get involved

Useful videos An introduction to measurement for improvement https://www.youtube.com/watch?v=Za1o77jAnbw 60 seconds with Kate Cheema Choosing measures http://www.haelo.org.uk/films/60-seconds-of-safety- with-kate-cheema-choosing-your-measures/ Using data effectively http://www.haelo.org.uk/films/60-seconds-of- safety-with-kate-cheema-using-your-datat-effectively/ Presenting your data http://www.haelo.org.uk/films/60-seconds-of- safety-with-kate-cheema-presenting-your-data/ How to become an improvement measure expert in 60 minutes https://prezi.com/3alg2jdmi5ea/how-to-become-an-improvement- measure-expert-in-60-minutes-final/ Using your data to drive action https://www.youtube.com/watch?v=YqUIsuzJwx4&feature=youtu.be A measurement for improvement community of interest has already been established. Within only a few weeks there are over 200 members. There are 40 useful resources and some lively discussion forums. Contact Sam to get involved