1. Measurement Vicki C. Grant, Director Supporting Families National Program Office covering kids & families Process Improvement Collaborative

2. How will we know that a change is an improvement? This collaborative is about redesigning systems to increase efficiency and effectiveness. It is not about measurement. covering kids & families Process Improvement Collaborative

3. Measurement Guidelines The question - How will we know that a change is an improvement? - usually requires more than 1 measure. A balanced set of 5 to 7 measures helps assure that the system is improved. Measures should reflect the aim & make it specific Measures are used to guide improvement and test changes Purpose is for learning not judgment Integrate measurement into daily routine Plot data measures over time and annotate graph with changes

4. My Data Assumptions All measures have limitations but, the limitations do not negate all value Measures are one voice of the system. Hearing the voice of the system gives us information on how to act with the system Measures tell a story; goals give a reference point covering kids & families Process Improvement Collaborative

5. Our Core Measures M1: Applications Received Number of applications received in the month M2: Percent Approvals 100 X approvals in the month ÷ total application decisions made in the month M3: Percent Denials 100 X denials in the month ÷ total application decisions made in the month M4: Denials by Reason100 X denials ÷ total denials M5: Percent Closures 100 X closures in the month ÷ cases at the beginning of the month + approvals in month M6: Closures by Reason 100 X cases closed by reason ÷ total closures M7: Percent of cases closed at renewal 100 X cases closed at renewal ÷ total cases scheduled for renewal M8: CaseloadCases beginning of month + approvals in month – closures in the month

6. Annotated Run Chart Plot small samples frequently over time Time Order (e.g., Month) Observed Data Value (e.g., Denial Rate) Change 1 tested Change 2 tested

7. Run Chart of Measures

8. Some Additional Measures Balancing measures – Customer satisfaction – Employee satisfaction – QC like audit Effect of reduced churning on managed care organizations Reduced uncompensated care costs at hospitals covering kids & families Process Improvement Collaborative