Module 4 Part 2 Selecting Measures Adapted from: The Institute for Healthcare Improvement (IHI), the Agency for Healthcare Research and Quality (AHRQ), and the Health Resources and Services Administration (HRSA) Quality Toolkits

Objectives Select measures for each AIM Identify types of measures (outcome, process, balancing/structure) Discuss the development of a family of measures for each aim, and access to data associated with those measures

Establishing Measures Model for Improvement: How will we know that a change is an improvement? Measurement is a critical part of testing and implementing changes Measures tell a team whether the changes they are making actually lead to improvement Measurement for improvement should not be confused with measurement for research

Selecting Measures Why are well defined measures important?

What does the concept defining data measures mean? Defining Measures What does the concept defining data measures mean? Data definitions Observed data points / subjective Patient-reported data / subjective Measured data points / objective

Steps in Defining Measures Defining what will be measured Different types of measures comprise a “family” Outcome Process Balancing or Structure

Include a Family of Measures Using a family of measures Rationale is to represent all areas of the quality of a problem Defining a “family” of measures Selecting a family of measures

Types of Performance Measures Outcome Process Structure

Family of Measures Type of Measure Description Care Transition FOM Outcome Are the care interventions effective? Patient outcome, voice of the customer, system performance, length of stay, etc. Medication reconciliation is accurate Type of Measure Description Care Transition FOM Outcome Are the care interventions effective? Patient outcome, voice of the customer, system performance, length of stay, etc. Medication reconciliation is accurate Process Are the steps in care delivery process working according to IOM STEEP quality criteria? Safe, timely, efficient, effective, equitably, patient-centered processes? RN used skill-based teaching method at discharge in 100% of patients Type of Measure Description Care Transition FOM Outcome Are the care interventions effective? Patient outcome, voice of the customer, system performance, length of stay, etc. Medication reconciliation is accurate Process Are the steps in care delivery process working according to IOM STEEP quality criteria? Safe, timely, efficient, effective, equitably, patient-centered processes? RN used skill-based teaching method at discharge in 100% of patients Balancing Using different clinical units, patient populations, or system characteristics to assess impact of a change Cost of medication reconciliation process is neutral

Select measures for each AIM Include a FAMILY of operational measures Summary Select measures for each AIM Include a FAMILY of operational measures Outcome Process Balancing / Structure